Transient dobutamine-mediated pulsus alternans.
Pulsus alternans, alternating weak and strong beats occurring in a heart beating at a constant rate, has most often been reported in patients with severe, end-stage heart failure. This patient with New York Heart Association functional class I heart failure developed pulsus alternans during the inotropic stimulation of dobutamine that subsequently resolved in a time course consistent with dobutamine clearance. Thus, in the setting of mildly impaired myocardial contractility, the inotropic stimulus of dobutamine may precipitate the development of reversible pulsus alternans.
Department of Internal Medicine, Division of Geriatric Medicine, Ann Arbor Healthcare System, Ann Arbor, MI 48105, USA.
J H
JH
Kahn
M R
MR
Starling
M A
MA
Supiano
D000368:Aged; D001145:Arrhythmias, Cardiac / Q000139:chemically induced* / Q000503:physiopathology; D002316:Cardiotonic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D004280:Dobutamine / Q000008:administration & dosage / Q000009:adverse effects*; D004562:Electrocardiography / Q000187:drug effects; D006333:Heart Failure / Q000188:drug therapy / Q000503:physiopathology; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D009200:Myocardial Contraction / Q000187:drug effects
D002316:Cardiotonic Agents; D004280:Dobutamine