ACUTE COMPLICATIONS IN DOBUTAMINE-ATROPIN E STRESS ECHOCARDIOGRAPHY

The presented case report describes lifethreatening complications of p harmacological stress echocardiography with dobutamine. A 66-year old male suffered an acute anterior wall myocardial infarction during dobu tamine-atropine stress echocardiography. Symptoms and signs of myocard ial infarction developed after maximal dobutamine-dose (40 mu g/kg/min ) and the additional application of atropine. Emergency coronary angio graphy revealed extensive coronary artery disease with proximal occlus ion of the left anterior descending artery which was successfully reca nalized. In a second patient ventricular fibrillation echocardiography and electrocardiographic signs of acute myocardial ischemia developed after high-dose dobutamine stress and required prolonged resuscitatio n. The possible mechanisms, incidence and risk of acute myocardial isc hemia during dobutamine-atropine stress are discussed and compared to bicycle ergometry. The presented life-threatening complications of dob utamine-atropine stressechocardiography emphasize the importance of av ailable and adequate emergency facilities.