title: Beta adrenergic receptor blockade causing severe left ventricular systolic dysfunction during dobutamine stress echocardiography in a patient with no structural heart disease.
abstract: A 41-year-old woman with a history of neurocardiogenic syncope treated with beta-blockers was admitted with chest pain. Dobutamine echocardiogram images demonstrated decreased global LV systolic wall motion and thickening. Coronary angiograms were normal. Beta-blockers were stopped and dobutamine stress echocardiogram (DSE) was repeated. Dobutamine images demonstrated increased global LV systolic wall motion and thickening. Beta-blockers were restarted and again dobutamine produced global LV dysfunction. This case suggests that DSE wall motion response may be falsely abnormal in a patient on beta-blockers. Physicians should be aware of this possibility when interpreting dobutamine echocardiography in patients taking beta-blockers.
authors: University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors: David R
authors: DR
authors: Okada
authors: Robert D
authors: RD
authors: Okada
authors: Robert O
authors: RO
authors: Bonow
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000494:pharmacology*; D000328:Adult; D003937:Diagnosis, Differential; D025401:Echocardiography, Stress / Q000187:drug effects*; D005260:Female; D006331:Heart Diseases; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D009248:Nadolol / Q000494:pharmacology*; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000139:chemically induced*; D016277:Ventricular Function, Left / Q000187:drug effects
chemical_list: D000319:Adrenergic beta-Antagonists; D009248:Nadolol