Key result
Normal dobutamine stress echocardiography precipitates acute inferior STEMI from in-stent thrombosis within 30 minutes.
Why the study?
Acute coronary syndrome after a normal dobutamine stress echocardiogram has been rarely reported, with unclear mechanisms of coronary occlusion.
Case Report (n=1)
Answers are grounded in this paper and cite their sources.
Dobutamine stress echocardiography can rarely trigger acute coronary syndrome, potentially through plaque destabilization and rupture.
Dobutamine stress echocardiogram (DSE) is considered a safe and reliable method for screening for underlying myocardial ischaemia. We report a case of a 60-year-old man who developed inferior ST-segment elevation myocardial infarction within 30 minutes of a normal DSE. The patient was found to have a 99% in-stent restenosis in the mid-right coronary artery with significant thrombosis for which successful percutaneous coronary intervention (PCI) was performed. Acute coronary syndrome after a normal DSE has been rarely reported in the literature. The reported cases were found to have obstructive or non-obstructive coronary plaques with overlying thrombus, which suggests plaque destabilisation and rupture as the possible underlying mechanism behind coronary occlusion.
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Gupta et al. (2019) conducted a case report in ST-segment elevation myocardial infarction and in-stent thrombosis (n=1). Dobutamine stress echocardiogram was evaluated on ST-segment elevation myocardial infarction. A 60-year-old man developed an inferior ST-segment elevation myocardial infarction due to 99% in-stent restenosis and thrombosis within 30 minutes of a normal dobutamine stress echocardiogram.
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