Key result
Dobutamine stress echocardiography induced late transient myocardial ischemia with ST-segment elevation 30 minutes post-infusion in an 80-year-old woman with normal coronary arteries.
Case Report (n=1)
This case highlights the potential for late dobutamine-induced coronary spasm after stress echocardiography, emphasizing the need for extended post-procedure monitoring.
May signal late ischemia risk after dobutamine stress echo; leaves open need for extended monitoring protocols.
Late complications after pharmacological stress echocardiography are infrequent but potentially dreadful events. We report the case of a 80-year-old woman admitted to hospital for rest chest pain with trivial troponin increase, normal left ventricular function and no significant ECG changes. A dobutamine stress echocardiography was performed for diagnostic purpose, with a negative result. About 30 min after the end of dobutamine infusion, she developed ST-segment elevation in inferior leads associated with chest pain and left ventricular dyssynergy, promptly resolved by sublingual nitrates. Subsequently, angiography documented the absence of significant coronary stenoses. The following clinical course was uneventful. Transient myocardial ischemia was likely due to dobutamine-induced coronary spasm. The case emphasizes the utility of routine, long-lasting monitoring of patients after stress echocardiography, even if negative, to counteract possible late life-threatening complications.
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Cabani et al. (2009) conducted a case report in Rest chest pain (n=1). Dobutamine stress echocardiography was evaluated on Late myocardial ischemia with ST-segment elevation. Dobutamine stress echocardiography induced late transient myocardial ischemia with ST-segment elevation 30 minutes post-infusion in an 80-year-old woman with normal coronary arteries.
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