title: New-onset seizure after perflutren microbubble injection during dobutamine stress echocardiography.
abstract: Intravenous microbubble contrast agents are frequently used during ultrasound imaging to improve endocardial border detection, enhance Doppler signals, differentiate thrombi from tumors or define vascular anatomy. Dobutamine stress echocardiography (DSE) with or without addition of atropine is a standard technique for evaluation of coronary artery disease. Noncontrast or contrast-enhanced DSE is generally considered a safe procedure. We report what appears to be the first case of new-onset seizure activity following perflutren microbubble contrast injection during dobutamine-atropine stress echocardiography. On the basis of this single occurrence, we are only able to demonstrate a temporal, but not a causal relationship between the administration of microbubble echo contrast and onset of seizure. We do not suggest withholding administration of microbubble contrast when clinically indicated. However, increased vigilance in monitoring for seizure development in patients receiving microbubble contrast seems warranted.
authors: Leon H. Charney Division of Cardiology, New York University Langone Medical Center, NY, USA.
authors: Adriana
authors: A
authors: Quiñones
authors: Ricardo
authors: R
authors: Benenstein
authors: Muhamed
authors: M
authors: Saric
mesh_terms: D004280:Dobutamine / Q000009:adverse effects*; D004452:Echocardiography / Q000009:adverse effects*; D005080:Exercise Test / Q000009:adverse effects*; D005260:Female; D005466:Fluorocarbons / Q000009:adverse effects*; D006801:Humans; D045423:Microbubbles / Q000009:adverse effects*; D008875:Middle Aged; D012640:Seizures / Q000139:chemically induced* / Q000175:diagnosis* / Q000517:prevention & control; D014665:Vasodilator Agents / Q000009:adverse effects
chemical_list: D005466:Fluorocarbons; D014665:Vasodilator Agents; D004280:Dobutamine; C042852:perflutren