[Evaluation of the safety of stress echocardiography in Spain and Portugal].
INTRODUCTION. There are few studies that evaluate the safety of stress echocardiography with discordant results. They are done in well-trained centers with highly selected populations leading to selection bias.


OBJECTIVE
To assess the safety of the different modalities of stress echocardiography in Spain and Portugal.


METHODS
Severe complications were retrospectively analyzed during the stress echocardiography performed in 29 hospitals in Portugal and Spain, from the beginning of their activity to September, 1999. In this period 22,105 stress echocardiograms were performed: 10,975 exercise echos, 2,969 low dose dobutamine echos, 6,832 high dose dobutamine echocardiograms, 1,276 dypiridamole echocardiograms, 41 paced echocardiograms and 12 with adenosine. A complication was defined as severe when it was life-threatening or led to hospital admission.


RESULTS
We registered 26 complications, one death, 3 ventricular fibrillations, 10 sustained ventricular tachycardias, 2 complete atrioventricular blocks, 6 acute myocardial infarctions, 2 ruptures of the free wall or ventricular septal defects, 1 transient ischemic attack and 1 severe symptomatic hypotension. We had one severe complication for every 2,743 exercise stress, 1 every 1,231 dypiridamole, 1 every 325 high dose dobutamine without any complications with low dose dobutamine stress. We found a relationship between experience in dobutamine stress echocardiography and the frequency of complications. Three complications appeared once the test was finished.


CONCLUSIONS
The stress echocardiography is a safe technique, but not harmless. The exercise stress echo is the safest of all the modalties of stress echocardiography. There is a relation between experience and the number of complications.
Rodríguez García
M A
MA
Servicio de Cardiología. Hospital de León.
Iglesias-Garriz
I
I
Corral Fernández
F
F
Garrote Coloma
C
C
Alonso-Orcajo
N
N
Branco
L
L
Picano
E
E
D000368:Aged; D002316:Cardiotonic Agents; D004280:Dobutamine; D004452:Echocardiography / Q000009:adverse effects* / Q000379:methods / Q000706:statistics & numerical data; D005080:Exercise Test / Q000009:adverse effects* / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D011174:Portugal; D012189:Retrospective Studies; D013030:Spain
D002316:Cardiotonic Agents; D004280:Dobutamine