Mid-ventricular variant of dobutamine-induced stress cardiomyopathy
Introduction: Dobutamine stress testing is a commonly used modality in detecting and estimating the prognosis in coronary artery disease (CAD). Although it is well tolerated by most patients, adverse events have been reported. Rarely, transient wall motion abnormalities can occur in the absence of o...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2015-01-01
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| Series: | Research in Cardiovascular Medicine |
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| Online Access: | http://www.rcvmonline.com/article.asp?issn=2251-9572;year=2015;volume=4;issue=2;spage=2;epage=2;aulast=Chandraprakasam;type=0 |
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| author | Satish Chandraprakasam Swapna Kanuri Claire Hunter |
| author_facet | Satish Chandraprakasam Swapna Kanuri Claire Hunter |
| author_sort | Satish Chandraprakasam |
| collection | DOAJ |
| description | Introduction: Dobutamine stress testing is a commonly used modality in detecting and estimating the prognosis in coronary artery disease (CAD). Although it is well tolerated by most patients, adverse events have been reported. Rarely, transient wall motion abnormalities can occur in the absence of obstructive CAD to suggest stress cardiomyopathy.
Case Presentation: We report a 48-year-old female with intermittent chest pain. Her physical exam, cardiac enzymes and transthoracic echocardiogram were unremarkable. She underwent dobutamine stress echocardiogram to rule out obstructive CAD. After 40 micrograms (mcg)/kg/minute and 0.5 mg atropine, she complained of intense chest pain and became hypertensive. Stress echocardiogram demonstrated mid-anterior and mid-septal hypokinesis. Emergent coronary angiogram demonstrated normal coronaries. Left ventricular angiogram in the right anterior oblique projection revealed mid-ventricular ballooning during systole with apical and basal hypercontractility. Patient demonstrated excellent recovery with expectant management.
Conclusions: The mechanism of mid-variant of Dobutamine-induced stress cardiomyopathy remains unclear. We think that multiple mechanisms are involved and this risk should be considered in patients with comorbid psychiatric conditions and with use of centrally acting stimulants. |
| first_indexed | 2024-12-12T09:24:29Z |
| format | Article |
| id | doaj.art-ed9d272a63cb4e869441fc1b061b4047 |
| institution | Directory Open Access Journal |
| issn | 2251-9572 2251-9580 |
| language | English |
| last_indexed | 2024-12-12T09:24:29Z |
| publishDate | 2015-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Research in Cardiovascular Medicine |
| spelling | doaj.art-ed9d272a63cb4e869441fc1b061b40472022-12-22T00:29:05ZengWolters Kluwer Medknow PublicationsResearch in Cardiovascular Medicine2251-95722251-95802015-01-01422210.5812/cardiovascmed.4(2)2015.25223Mid-ventricular variant of dobutamine-induced stress cardiomyopathySatish ChandraprakasamSwapna KanuriClaire HunterIntroduction: Dobutamine stress testing is a commonly used modality in detecting and estimating the prognosis in coronary artery disease (CAD). Although it is well tolerated by most patients, adverse events have been reported. Rarely, transient wall motion abnormalities can occur in the absence of obstructive CAD to suggest stress cardiomyopathy. Case Presentation: We report a 48-year-old female with intermittent chest pain. Her physical exam, cardiac enzymes and transthoracic echocardiogram were unremarkable. She underwent dobutamine stress echocardiogram to rule out obstructive CAD. After 40 micrograms (mcg)/kg/minute and 0.5 mg atropine, she complained of intense chest pain and became hypertensive. Stress echocardiogram demonstrated mid-anterior and mid-septal hypokinesis. Emergent coronary angiogram demonstrated normal coronaries. Left ventricular angiogram in the right anterior oblique projection revealed mid-ventricular ballooning during systole with apical and basal hypercontractility. Patient demonstrated excellent recovery with expectant management. Conclusions: The mechanism of mid-variant of Dobutamine-induced stress cardiomyopathy remains unclear. We think that multiple mechanisms are involved and this risk should be considered in patients with comorbid psychiatric conditions and with use of centrally acting stimulants.http://www.rcvmonline.com/article.asp?issn=2251-9572;year=2015;volume=4;issue=2;spage=2;epage=2;aulast=Chandraprakasam;type=0Cardiomyopathy; Takotsubo Cardiomyopathy; EchocardiographyStress |
| spellingShingle | Satish Chandraprakasam Swapna Kanuri Claire Hunter Mid-ventricular variant of dobutamine-induced stress cardiomyopathy Research in Cardiovascular Medicine Cardiomyopathy; Takotsubo Cardiomyopathy; Echocardiography Stress |
| title | Mid-ventricular variant of dobutamine-induced stress cardiomyopathy |
| title_full | Mid-ventricular variant of dobutamine-induced stress cardiomyopathy |
| title_fullStr | Mid-ventricular variant of dobutamine-induced stress cardiomyopathy |
| title_full_unstemmed | Mid-ventricular variant of dobutamine-induced stress cardiomyopathy |
| title_short | Mid-ventricular variant of dobutamine-induced stress cardiomyopathy |
| title_sort | mid ventricular variant of dobutamine induced stress cardiomyopathy |
| topic | Cardiomyopathy; Takotsubo Cardiomyopathy; Echocardiography Stress |
| url | http://www.rcvmonline.com/article.asp?issn=2251-9572;year=2015;volume=4;issue=2;spage=2;epage=2;aulast=Chandraprakasam;type=0 |
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