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Dobutamine-induced transmural myocardial ischemia in a patient with mild coronary lesions
F G Kardaras1, M S Bonou, D F Kardara
1First Department of Cardiology, Evangelismos Hospital, Athens, Greece.
Clinical Cardiology
|February 1, 1996
Abstract:
A 70-year-old man was admitted for evaluation of retrosternal pain at rest. During infusion of dobutamine (25 micrograms/kg/min) the patient developed angina, ST-segment elevation in the inferior leads, and echocardiographic hypokinesia in the inferior-basal myocardial wall. Coronary angiography revealed insignificant (20-30%) stenosis of the right coronary artery and a normal remaining tree. This case suggests that dobutamine may induce transmural myocardial ischemia in patients with mild coronary lesions, probably by producing occlusive coronary spasm on a substrate of arterial endothelial dysfunction.