A 53-year-old woman with atypical chest pain underwent a dobutamine stress echocardiogram (DSE) and developed a coronary spasm (CS) with severe pain and dramatic ST-segment elevation 9 min after dobutamine infusion was discontinued. The spasm resolved after sublingual nitroglycerin administration. The same-day coronary angiogram showed non-significant stenosis in the three coronary territories. Retrospectively, we found that the patient had vasospastic angina (VSA), a condition that has been strongly associated with the development of dobutamine-induced CS. Mechanisms of dobutamine-induced CS are not fully understood and include endothelial dysfunction leading to deficient nitric oxide-mediated coronary vasodilation in response to increased myocardial oxygen demand as well as imbalance between β1 and β2 adrenergic effects of dobutamine. Dobutamine-induced CS has also been much more frequently reported in patients from Asian descent with VSA. VSA should be systemically recognised in patients considered for DSE and, if present, other modalities of stress imaging should be discussed.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7462237 | PMC |
| http://dx.doi.org/10.1136/bcr-2020-235206 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Effects of Isoproterenol Administration in Dobutamine Stress Echocardiography.
Echocardiography
February 2025
Department of Cardiology, MedStar Georgetown University Hospital, Washington, DC, USA.
Objective: This study evaluated the safety and efficacy of isoproterenol administration as an adjunct for achievement of target heart rate (HR) during dobutamine stress echocardiography (DSE).
Background: In DSE, optimal accuracy is achieved when a target HR of 85% of maximal predicted heart rate (MPHR) is attained. Although rarely studied, intravenous isoproterenol has been used as an adjunct therapy to dobutamine and atropine to increase chronotropic response during pharmacologic stress testing.
Stress-induced cardiomyopathy by dobutamine stress echocardiography during recovery stage - A rare presentation.
J Cardiol Cases
October 2024
Department of Cardiovascular Diseases, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Unlabelled: Stress-induced cardiomyopathy is a condition of acute myocardial suppression following an abrupt release of endogenous catecholamines after emotional or physical stress. The exact mechanism is unknown but there are reports of a similar clinical presentation after injection of exogenous catecholamines such as beta agonists. We report a rare type of stress-induced cardiomyopathy following injection of dobutamine during a diagnostic stress echocardiography.
View Article and Find Full Text PDFHemodynamic Relevance Evaluation of Coronary Artery Anomaly During Stress Using FFR/IVUS in an Artificial Twin.
JACC Case Rep
January 2025
Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Anomalous aortic origin of coronary artery can lead to ischemia. Due to the limitations of invasive catheterization dobutamine stress testing, an alternative noninvasive approach is desired. A 65-year-old woman with atypical chest pain was referred for coronary computed tomography angiography.
View Article and Find Full Text PDFHemodynamic response of the aortic valve during dobutamine onset then progressive aortic banding.
Am J Physiol Heart Circ Physiol
January 2025
Weatherhead P.E.T. Imaging Center, McGovern Medical School at UTHealth, Houston, Texas, USA.
An increasing number of procedures over the past two decades for aortic stenosis (AS) reflects the combination of an aging population and less invasive transcatheter options. As a result, the hemodynamics of the aortic valve (AV) have gained renewed interest to understand its behavior and to optimize patient selection. We studied the hemodynamic relationship between pressure loss (ΔP) and transvalvular flow (Q) of the normal AV as well as the impact of a variable supravalvular stenosis.
View Article and Find Full Text PDFAortic Valve Plasty for Coexistence of Discrete Subvalvular Aortic Stenosis and Quadricuspid Aortic Valve: A Case Report.
Cureus
December 2024
Cardiovascular Surgery, Ayase Heart Hospital, Tokyo, JPN.
Subvalvular aortic stenosis typically manifests at a young age and rarely presents in adulthood. It may cause left ventricular outflow tract stenosis, which requires surgical treatment in severe cases. The coexistence of discrete subvalvular aortic stenosis and quadricuspid aortic valve is a highly unusual finding.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!