Myocardial infarction as a complication of dobutamine stress echocardiography.
Only few cases of myocardial infarction complicating dobutamine stress echocardiography have been reported. We observed a 42-year-old woman in whom acute inferior wall infarction developed 10 minutes after discontinuation of dobutamine stress echocardiography with up to 20 micrograms/kg/min dobutamine. The right coronary artery, which had had a 50% stenosis in the prior angiography, showed proximal complete occlusion on the immediately performed recatheterization. Thrombolysis in myocardial infarction study flow grade 3 was rapidly accomplished by intracoronary thrombolysis with recombinant tissue type plasminogen activator. For recurrent unstable angina, the patient received coronary bypass grafting on the same day. The case shows that myocardial infarction not preceded by regional wall motion abnormalities is a possible complication of dobutamine stress echocardiography. Post-test monitoring even after negative tests is recommended.
Weidmann
B
B
Department of Medicine, Leverkusen Teaching Hospital, Germany.
Lepique
C U
CU
Jansen
W
W
Stoiber
W U
WU
Tauchert
M O
MO
D000318:Adrenergic beta-Agonists / Q000009:adverse effects*; D000328:Adult; D000789:Angina, Unstable / Q000601:surgery; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000503:physiopathology; D004280:Dobutamine / Q000009:adverse effects*; D004452:Echocardiography / Q000009:adverse effects*; D005260:Female; D006801:Humans; D009203:Myocardial Infarction / Q000188:drug therapy / Q000209:etiology*; D017202:Myocardial Ischemia / Q000601:surgery; D010960:Plasminogen Activators / Q000627:therapeutic use; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use
D000318:Adrenergic beta-Agonists; D004280:Dobutamine; D010960:Plasminogen Activators; D010959:Tissue Plasminogen Activator