[Complications of stress-echocardiography used for diagnosis of ischemic heart disease]

Kardiologiia. 2008;48(1):19-23.
[Article in Russian]

Abstract

Prevalence of minor and major complications, side effects of stress echocardiography (stress-echoCG) was studied in a group of 1359 patients with suspected ischemic heart disease (IHD). Dipyridamole/atropine test was carried out in 184, dobutamine/atropine test - in 231, transesophageal atrial pacing (TEAP) - in 154, veloergometry (VEM) in half sitting position - in 122, and combination stress-echoCG - in 668 patients (dipyridamole/TEAP, n=151; dipyridamole/dobutamine, n=162; dipyridamole/paired TAP, n=112). We classified ventricular and supraventricular extrasystoles, head ache, nausea, muscular tremor as side effects, short paroxysms (less than 2 min) of hemodynamically insignificant supraventricular and ventricular tachycardia - as minor complications, and development of acute coronary syndrome, ventricular fibrillation - as major complications. Most frequent side effects during stress-echoCG were rare ventricular extrasystoles (26.0% during dobutamine, 18.9% during VEM test), and head ache (16,7% in dipyridamole tests). Major complications occurred in 2 cases (0,147%). One patient during standard dipyridamole test developed acute coronary syndrome requiring urgent coronary angiography and angioplasty of the right coronary artery. Another patient after administration of 0.25 ml of 0.1% atropine solution at the background of dobutamine infusion (40 mcg/kg/min) had ventricular fibrillation requiring resuscitative measures. Although stress-echoCG in general is a safe and highly informative method of diagnosis of IHD it can be accompanied with side effects during action of stress-agents, minor and major complications during conduction of tests. This dictates necessity of obtainment of compulsory informed consent from patients.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Arrhythmias, Cardiac / etiology*
  • Arrhythmias, Cardiac / physiopathology
  • Cardiotonic Agents / adverse effects
  • Dipyridamole / adverse effects
  • Dobutamine / adverse effects
  • Echocardiography, Stress / adverse effects*
  • Female
  • Heart Rate / physiology
  • Humans
  • Male
  • Middle Aged
  • Myocardial Ischemia / diagnostic imaging*
  • Myocardial Ischemia / physiopathology
  • Risk Factors
  • Vasodilator Agents / adverse effects

Substances

  • Cardiotonic Agents
  • Vasodilator Agents
  • Dobutamine
  • Dipyridamole