A 55-year-old man developed hypertension and acute epigastric pain during dobutamine-atropine stress echocardiography (DASE). Evaluation-including a helical computed tomography (CT) scan of the abdomen and pelvis, as well as surgical exploration-revealed a ruptured splenic artery aneurysm. The patient died, despite multiple surgical interventions and a massive blood product transfusion. Impressively, no deaths from DASE have been previously reported. Additionally, no adverse sequelae during DASE have been reported in patients with an unruptured abdominal aortic aneurysm >or=4 cm in diameter or with an unruptured intracranial aneurysm. We report the first case, to our knowledge, of death caused by splenic artery aneurysm rupture during DASE. Splenic artery aneurysm rupture during DASE, though rare, can lead to death.
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