title: Provocation of coronary spasm by dobutamine stress echocardiography in a patient with angiographically minimal coronary artery disease.
abstract: Dobutamine stress echocardiography (DSE) has been widely used for the noninvasive diagnosis of obstructive coronary artery disease. The ST-segment elevation during DSE has been reported as an infrequent event, caused by old myocardial infarction and/or critical coronary narrowings. The patient presented here was a 35-year-old man with a recent history of nonexertional chest pain. He had hypercholesterolemia and a history of heavy smoking as risk factors. The patient developed ST-segment elevation with chest pain during 40 mcg/min dobutamine infusion for the stress echocardiographic examination. Subsequent coronary angiograms revealed only mild coronary atherosclerosis. It is speculated that coronary spasm occurred in this patient as a paradoxical response to increased coronary blood flow with dobutamine administration.
authors.affiliation: Department of Internal Medicine, University of Nebraska Medical Center, Omaha 68198-2265, USA.
authors.forename: U
authors.initials: U
authors.lastname: Deligonul
authors.forename: R
authors.initials: R
authors.lastname: Armbruster
authors.forename: A
authors.initials: A
authors.lastname: Hailu
mesh_terms: D000328:Adult; D000788:Angina Pectoris, Variant / Q000209:etiology* / Q000503:physiopathology; D002316:Cardiotonic Agents; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging; D004280:Dobutamine; D004452:Echocardiography / Q000009:adverse effects*; D006801:Humans; D008297:Male
chemical_list: D002316:Cardiotonic Agents; D004280:Dobutamine