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.
Kahn
J H
JH
Department of Internal Medicine, Division of Geriatric Medicine, Ann Arbor Healthcare System, Ann Arbor, MI 48105, USA.
Starling
M R
MR
Supiano
M A
MA
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