Coronary Artery Spasm During Dobutamine Stress Echocardiography: A Case Report

Document Type: Case Report

Authors

1 Cardiologist, Atherosclerosis Prevention Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Interventionist, Atherosclerosis Prevention Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

3 Cardiac Surgeon, Cardiovascular Research Center, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranResearch Center, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

4 Interventionist, Razavi Hospital, Mashhad, Iran

Abstract

Dobutamine stress echocardiography (DSE) has been widely used as a diagnostic and prognostic modality in the management of stress. DSE is associated with limited complications and adverse effects on the health of patients. In this case report, we described a 42-year-old female patient with dobutamine-induced coronary artery spasm with history of exertional dyspnea, which had deteriorated recently. No risk factors of coronary artery disease were observed in the patient, and she had previous non-diagnostic exercise tolerance test. DSE was performed on the patient, and at the end of the infusion rate of 30 mcg/min, retrosternal pain was detected. Standard 12-lead electrocardiogram was indicative of ST segment elevation in inferior leads. Moreover, echocardiographic imaging of the patient revealed concomitant akinesia in the right coronary artery. On the other hand, subsequent coronary angiograms showed only mild coronary atherosclerosis.

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1.         Rosado PRB, Gil MA, Campos Filho O. Coronary Spasm during the Dobutamine Stress Echocardiography. Arq Bras Cardiol. 2014;27(2):97-100.
2.         Geleijnse ML, Krenning BJ, Nemes A, van Dalen BM, Soliman OI, Folkert J, et al. Incidence, pathophysiology, and treatment of complications during dobutamine-atropine stress echocardiography. Circulation. 2010;121(15):1756-67.
3.         Mansencal N, El Hajjaji I, El Mahmoud R, Digne F, Dubourg O. Prevalence of coronary artery spasm during dobutamine stress echocardiography. The American journal of cardiology. 2012;109(6):800-4.
4.         Kawano H, Ogawa H. Endothelial function and coronary spastic angina. Internal medicine. 2005;44(2):91-9.
5.         Yasue H. PAthophysiology and treatment of coronary arterial spasm. Chest. 1980;78(1_Supplement):216-23.
6.         Álvarez L, Zamorano J, Mataix L, Almeria C, Moreno R, Rodrigo JL. Coronary spasm after administration of propranolol during dobutamine stress echocardiography. Revista Española de Cardiología. 2002;55(07):778-81.
7.         Tio RA, Van Gelder IC, Boonstra PW, Crijns H. Myocardial bridging in a survivor of sudden cardiac near-death: role of intracoronary doppler flow measurements and angiography during dobutamine stress in the clinical evaluation. Heart. 1997;77(3):280-2.
8.         Kawano H, Fujii H, Motoyama T, Kugiyama K, Ogawa H, Yasue H. Myocardial ischemia due to coronary artery spasm during dobutamine stress echocardiography. The American journal of cardiology. 2000;85(1):26-30.