Mid-ventricular variant of dobutamine-induced stress cardiomyopathy

Abstract

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. 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.

A rare case of atypical mid-variant takotsubo cardiomyopathy during dobutamine stress echocardiography (RCD code: III-5B)

“…The occurrence of ST-segment elevation during DSE is rare and largely reported as case reports [4][5][6][7][8], however, dobutamine has also been implicated in the aetiology of takotsubo cardiomyopathy [9][10][11][12][13][14]. Atypical variants of TCMP including the basal [15] and mid ventricular variant [16] with DSE have also been previously described.…”

“…The mechanism of dobutamine-induced TCMP remains unclear and numerous theories have been put forward to explain the aetiology including the occurrence of multi-vessel coronary vasospasm due to catecholamine surge, a transient LV outflow tract obstruction, or mid cavity obstruction due to systolic anterior motion of the mitral leaflet and drug-induced hypertension [15][16][17].…”