Provocation of coronary spasm by dobutamine stress echocardiography in a patient with angiographically minimal coronary artery disease.
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.
Deligonul
U
U
Department of Internal Medicine, University of Nebraska Medical Center, Omaha 68198-2265, USA.
Armbruster
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R
Hailu
A
A
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
D002316:Cardiotonic Agents; D004280:Dobutamine