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Cardiac Stress Test Induced by Dobutamine and Monitored by Cardiac Catheterization in Mice
15:45

Cardiac Stress Test Induced by Dobutamine and Monitored by Cardiac Catheterization in Mice

Published on: February 10, 2013

Acute myocardial infarction after a negative dobutamine stress echocardiogram

Abdou Elhendy1, Wilson Ginete, Scott Shurmur

  • 1Department of Internal Medicine, Section of Cardiology, University of Nebraska Medical Center, Omaha, NE 68198-2265, USA. aelhendy@unmc.edu

European Journal of Echocardiography : the Journal of the Working Group on Echocardiography of the European Society of Cardiology
|November 24, 2004
PubMed

Insights

Acute myocardial infarction (MI) is a rare complication of dobutamine stress echocardiography (DSE). MI after DSE can occur with non-obstructive coronary artery disease due to plaque destabilization from high shear stress.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Interventional Cardiology

Background:

  • Dobutamine stress echocardiography (DSE) is a common diagnostic tool.
  • Acute myocardial infarction (MI) is a rare but serious complication of DSE.

Observation:

  • A patient developed acute inferior ST-elevation MI two hours after a normal DSE.
  • The patient's coronary angiography revealed 60% stenosis of the proximal right coronary artery.
  • A complex, ulcerated plaque with intracoronary thrombus was identified.

Findings:

  • Myocardial infarction following DSE can occur in the absence of severe obstructive coronary artery disease.
  • High shear stress during DSE may destabilize complex plaques.
  • Plaque destabilization can lead to thrombotic occlusion and MI.

Implications:

  • This case challenges the assumption that MI post-DSE only occurs with critical coronary stenosis.
  • It highlights the potential role of plaque vulnerability and shear stress in DSE-induced MI.
  • Clinicians should consider plaque characteristics and shear stress effects in patients experiencing MI after DSE.

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