title: Coronary spasm induced by dobutamine-atropine stress echocardiography.
abstract: This is the report on a 45-year-old female, with a history of systemic arterial hypertension and cigarette smoking, submitted to dobutamine-atropine stress echocardiography for the investigation of coronary artery disease. At stress peak, the patient reported sudden, highly intense precordial pain. The 12-lead electrocardiogram showed ST segment elevation in DII, DIII, aVF, V5 and V6, and depression in DI, aVL, V2 and V3. Echocardiographic imaging monitoring showed dyskinesia of inferior septum and akinesia of inferior wall. The test was interrupted immediately. The patient was medicated and improved her precordial pain condition as well as wall motion abnormalities. Coronary angiography showed irregular coronary lesions with <50% luminal diameter obstruction. It is a case of coronary spasm induced by alpha-adrenergic stimulation during dobutamine-atropine stress echocardiography.
authors.affiliation: Instituto do Coração, Hospital das Clínicas, FM, USP, São Paulo, SP, Brazil.
authors.forename: Fábio A
authors.initials: FA
authors.lastname: Bogaz
authors.forename: Ally N R
authors.initials: AN
authors.lastname: Saroute
authors.forename: Jeane Mike
authors.initials: JM
authors.lastname: Tsutsui
authors.forename: Ingrid
authors.initials: I
authors.lastname: Kowatsch
authors.forename: Francisco M
authors.initials: FM
authors.lastname: O Neto
authors.forename: José C
authors.initials: JC
authors.lastname: Nicolau
authors.forename: José A F
authors.initials: JA
authors.lastname: Ramires
authors.forename: Wilson
authors.initials: W
authors.lastname: Mathias Junior
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000009:adverse effects*; D001285:Atropine / Q000009:adverse effects*; D017023:Coronary Angiography; D003329:Coronary Vasospasm / Q000139:chemically induced* / Q000000981:diagnostic imaging; D004280:Dobutamine / Q000009:adverse effects*; D025401:Echocardiography, Stress / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008875:Middle Aged
chemical_list: D000319:Adrenergic beta-Antagonists; D004280:Dobutamine; D001285:Atropine