title: Safety of dobutamine stress echocardiography in 474 consecutive studies.
abstract: BACKGROUND
  With expanding applications and increasingly aggressive stress protocols, concerns about the safety of dobutamine stress echocardiography (DSE) have arisen. The purpose of this study was to analyse prospectively the safety, adverse event profile and complication rate of DSE.
  
  
  METHODS
  Prospective data were recorded in a consecutive series of 474 patients undergoing DSE. Dobutamine was administered intravenously in graded infusion, each stage over 3 min, at 10, 20, 40 and, if required, 50 micrograms/kg/min. Atropine (1 mg) was administered thereafter if the response remained suboptimal.
  
  
  RESULTS
  The mean dose of dobutamine was 42 micrograms/kg/min, with 111 patients (23%) receiving 50 micrograms/kg/min. Atropine was required for 27 patients (6%). No patient died or suffered a myocardial infarction. Sustained ventricular tachycardia occurred in one patient, angina pectoris in 127 (27%), non-sustained ventricular tachycardia in eight (2%) and supraventricular tachycardia in 19 (4%). Profound bradycardia requiring cessation of the test occurred in one patient. Pulmonary oedema developed in one patient. A hypotensive response requiring cessation of the test was seen in one patient. Test termination because the patient complained of nausea, tremor or headache was not required.
  
  
  CONCLUSIONS
  DSE is safe. Side effects are rare and when they occur, are usually minor. Ischaemic pain is effectively treated by termination of the test and sublingual administration of nitrates.
authors.affiliation: Cardiovascular Research Group, Mater Misericordiae Hospital, Dublin, Ireland.
authors.forename: T G
authors.initials: TG
authors.lastname: Hennessy
authors.forename: M B
authors.initials: MB
authors.lastname: Codd
authors.forename: G
authors.initials: G
authors.lastname: Kane
authors.forename: C
authors.initials: C
authors.lastname: McCarthy
authors.forename: H A
authors.initials: HA
authors.lastname: McCann
authors.forename: D D
authors.initials: DD
authors.lastname: Sugrue
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000209:etiology; D001145:Arrhythmias, Cardiac / Q000209:etiology; D002316:Cardiotonic Agents / Q000009:adverse effects; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004280:Dobutamine / Q000009:adverse effects; D004452:Echocardiography / Q000009:adverse effects / Q000379:methods*; D004562:Electrocardiography; D005080:Exercise Test / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012449:Safety
chemical_list: D002316:Cardiotonic Agents; D004280:Dobutamine