Differential effects of dobutamine versus treadmill exercise on left ventricular volume and wall stress.

Background: Dobutamine and exercise echocardiography are well-validated modalities used for the evaluation of patients with suspected myocardial ischemia. Patients undergoing dobutamine stress echocardiography (DSE), however, experience less angina, ST-segment depressions, and wall motion abnormalities. Other than the effect on heart rate, the physiologic and volumetric differences between pharmacologic and exercise-induced stress that affect myocardial oxygen demand are not well defined.

Very large incidental pericardial effusion attributable to minoxidil: resolution without drainage.

We present a case of drug-induced pericardial effusion in a patient with end-stage renal disease. Hypertension is frequent among patients with chronic renal failure and sometimes it is necessary to use agents, like minoxidil. Many papers have reported the association between minoxidil and pericardial effusion, both in dialysis patients and those with normal renal function.

Prevalence and clinical characteristics of nondilated cardiomyopathy and the effect of atrial fibrillation.

The treatment of patients with chronic heart failure and those with asymptomatic left ventricular (LV) dysfunction has focused primarily on patients with LV enlargement and a low ejection fraction (EF). Little attention has been paid to those with a normal chamber size and a low EF. We sought to examine the LV geometry and clinical characteristics in such patients with nondilated cardiomyopathy.

Cardiac events in patients with negative maximal versus negative submaximal dobutamine echocardiograms undergoing noncardiac surgery: importance of resting wall motion abnormalities.

Objectives: This study sought to evaluate the negative predictive value (NPV) of preoperative dobutamine stress echocardiography (DSE) in patients who fail to achieve target heart rate (HR) and assess the influence of resting wall motion abnormalities (WMAs) without demonstrable ischemia on perioperative events.

Background: The prognostic value of a negative-submaximal DSE study before noncardiac surgery is unknown.

Methods: Consecutive patients (n = 429) who underwent surgery over a three-year period, preceded by DSE, were included.

Paradoxical embolism in the left main coronary artery: diagnosis by transesophageal echocardiography.

We describe a patient with a paradoxical coronary embolism diagnosed by transesophageal echocardiography. The patient developed a stroke followed by a myocardial infarction. Coronary angiography showed an obstruction of the left main coronary artery.