[Acute myocardial infarction with cardiogenic shock following stress echocardiography: case report]

Area of Science:

• Cardiology
• Cardiovascular Imaging
• Interventional Cardiology

Background:

• Dobutamine stress echocardiography (DSE) is a common diagnostic tool for assessing coronary artery disease.
• Acute myocardial infarction (AMI) is a recognized but infrequent complication of DSE.
• Identifying risk factors and management strategies for DSE-induced AMI is crucial.

Observation:

• A 60-year-old male patient with a history of myocardial infarction (MI) underwent DSE.
• The DSE was positive in the inferior topography, indicating significant coronary artery disease.
• Two hours post-DSE, the patient developed cardiogenic shock and circulatory arrest.

Findings:

• Emergency coronary angiography revealed a dissection of the circumflex artery.
• The patient required mechanical circulatory support for survival.
• The underlying cause was attributed to the stress induced by DSE in a compromised arterial segment.

Implications:

• This case highlights a rare but severe complication of DSE, emphasizing the need for careful patient selection and monitoring.
• Circumflex artery dissection following DSE can lead to acute cardiogenic shock and circulatory arrest.
• Prompt recognition and intervention, including circulatory support, are vital for patient survival and improved outcomes in such critical events.