[Coronary Spasm after Administration of Propranolol during Dobutamine Stress Echocardiography].
Dobutamine stress echocardiography, a highly useful and safe challenge test for myocardial ischemia, is being used increasingly. We report the case of a 37-year-old man with rest angina, repolarization abnormalities in precordial leads and normal coronary arteries who was referred for dobutamine-atropine stress echocardiography, which was negative for ischemia. However, after testing, upon injection of propranolol, the patient suffered chest pain associated with ST elevation and severe regional systolic abnormalities. After intravenous nitroglycerin administration, chest pain and electrocardiographic abnormalities disappeared quickly, and systolic motion became normal. This complication was interpreted as a coronary spasm. We discuss the causes for the spasm and the role that might have been played by the drugs employed.
Servicio de Cardiología, Hospital Clínico San Carlos, Madrid, Spain.
Lucía
L
Alvarez
José
J
Zamorano
Luis
L
Mataix
Carlos
C
Almeria
Raúl
R
Moreno
José Luis
JL
Rodrigo
D000319:Adrenergic beta-Antagonists / Q000009:adverse effects*; D000328:Adult; D000787:Angina Pectoris / Q000139:chemically induced*; D002637:Chest Pain / Q000175:diagnosis; D004280:Dobutamine; D004452:Echocardiography; D004562:Electrocardiography; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011433:Propranolol / Q000009:adverse effects*; D013997:Time Factors
D000319:Adrenergic beta-Antagonists; D004280:Dobutamine; D011433:Propranolol