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

Published on: February 10, 2013

Spontaneous coronary artery dissection during a dobutamine stress echocardiography

Ilias Karabinos1, Anastasios Papadopoulos, Spyridon Koulouris

  • 1Cardiology Department Echo Laboratory, Euroclinic of Athens, Athens, Greece. iliaskk@in.gr

Echocardiography (Mount Kisco, N.Y.)
|March 10, 2006
PubMed

Insights

A spontaneous right coronary artery dissection occurred during dobutamine stress echocardiography (DSE). This rare event caused chest pain and EKG changes, confirmed by coronary angiography.

Area of Science:

  • Cardiology
  • Diagnostic Imaging
  • Interventional Cardiology

Background:

  • Dobutamine stress echocardiography (DSE) is a common non-invasive test for diagnosing coronary artery disease.
  • Spontaneous coronary artery dissection (SCAD) is a rare but serious condition.
  • SCAD can present with symptoms mimicking acute myocardial infarction.

Observation:

  • A middle-aged male patient undergoing DSE experienced sudden, severe retrosternal chest pain.
  • Electrocardiogram (EKG) showed significant ST-segment elevation in multiple leads (II, III, aVF, V5-V6).
  • An accelerated idioventricular rhythm was observed concurrently with chest pain and EKG changes.

Findings:

  • Coronary angiography revealed a minor spontaneous dissection of the distal right coronary artery.
  • The dissection was identified as the cause of the patient's symptoms during DSE.
  • This case highlights a rare complication associated with dobutamine stress testing.

Implications:

  • Clinicians should consider SCAD in patients experiencing acute chest pain during DSE, even without typical risk factors.
  • Prompt recognition and diagnostic workup, including coronary angiography, are crucial for managing such events.
  • This case underscores the importance of awareness regarding potential iatrogenic or stress-induced coronary artery events.

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