Left ventricular outflow tract and mid-cavity obstruction may cause false-positive dobutamine stress echocardiograms.
Left ventricular (LV) outflow tract obstruction (LVOTO) occurs in up to 20% of patients undergoing dobutamine stress echocardiography (DSE). Mid-cavity LV obstruction occurs less commonly during DSE. LV regional wall motion abnormalities during DSE may occur despite normal coronaries due to hypertensive blood pressure response and takotsubo stress cardiomyopathy. We describe herein two cases of LVOTO and one case of mid-cavity LV obstruction during DSE associated with transient apical hypokinesis.
Department of Internal Medicine, Division of Cardiovascular Medicine, University of Missouri School of Medicine, Columbia, MO 65212, USA.
Manish B
MB
Jhawar
Sudarshan
S
Balla
Martin A
MA
Alpert
Anand
A
Chockalingam
D000328:Adult; D001795:Blood Pressure Determination; D002637:Chest Pain / Q000175:diagnosis / Q000209:etiology; D017023:Coronary Angiography / Q000379:methods; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000188:drug therapy; D003937:Diagnosis, Differential; D025401:Echocardiography, Stress / Q000379:methods*; D004562:Electrocardiography / Q000379:methods; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008875:Middle Aged; D012494:Sampling Studies; D012720:Severity of Illness Index; D014694:Ventricular Outflow Obstruction / Q000000981:diagnostic imaging* / Q000503:physiopathology