RESUMEN
Dobutamine echocardiography has become widely used in the past decade in the evaluation of patients with suspected coronary artery disease who are unable to undergo exercise treadmill or bicycle testing. The safety of this procedure has been studied in a hospital-based setting. However, no studies thus far have evaluated the safety of this procedure in an office-based setting, remote from a hospital. We performed dobutamine echocardiography on 127 patients in an office-based setting, remote from a hospital. Throughout the course of this study there were no deaths, myocardial infarctions, sustained episodes of ventricular tachycardia, or syncopal episodes associated with dobutamine infusion. The frequency of noncardiac side effects was 29%, the majority of which were nausea, vomiting, and paresthesias. Three patients had nonsustained ventricular tachycardia, none of whom had symptoms. We conclude that dobutamine echocardiography is safe, well tolerated, and useful in an office-based setting.
Asunto(s)
Atención Ambulatoria , Dobutamina , Ecocardiografía , Prueba de Esfuerzo , Adulto , Anciano , Anciano de 80 o más Años , Dobutamina/efectos adversos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Contracción Miocárdica/efectos de los fármacos , Náusea/inducido químicamente , Parestesia/inducido químicamente , Taquicardia Ventricular/inducido químicamente , Vómitos/inducido químicamenteRESUMEN
The detection of silent myocardial ischemia in patients presenting to emergency departments with atypical chest pain remains problematic. We describe the case of a patient with silent ischemia detected by continuous ST-segment monitoring, resulting in the prompt institution of therapeutic modalities.