title: Central anticholinergic syndrome following dobutamine-atropine stress echocardiography.
abstract: We present a case of central anticholinergic syndrome following dobutamine-atropine stress echocardiography in an elderly female. Although atropine toxicity is a recognized complication of stress echocardiography, no case reports are currently available. The central nervous system side effects of atropine are varied in severity (mild cognitive impairment to severe coma) and spectrum (agitation or somnolence), and thus are often overlooked. Management includes prompt recognition, stopping the offending agent, providing supportive care, and consideration of physiostigmine. Atropine is used in up to 60% of dobutamine stress echocardiograms, and has the potential to cause morbidity.
authors.affiliation: Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Wilson
authors.forename: Glenn K
authors.initials: GK
authors.lastname: Lee
authors.forename: Anupam
authors.initials: A
authors.lastname: Chandra
authors.forename: Garvan C
authors.initials: GC
authors.lastname: Kane
mesh_terms: D000369:Aged, 80 and over; D001285:Atropine / Q000009:adverse effects*; D001927:Brain Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging*; D018680:Cholinergic Antagonists / Q000009:adverse effects*; D004280:Dobutamine / Q000009:adverse effects*; D004359:Drug Therapy, Combination / Q000009:adverse effects; D005080:Exercise Test / Q000009:adverse effects*; D005260:Female; D006801:Humans; D018727:Muscarinic Antagonists / Q000009:adverse effects*; D013577:Syndrome; D014463:Ultrasonography; D014665:Vasodilator Agents / Q000009:adverse effects
chemical_list: D018680:Cholinergic Antagonists; D018727:Muscarinic Antagonists; D014665:Vasodilator Agents; D004280:Dobutamine; D001285:Atropine