Dobutamine
- PDF / 141,467 Bytes
- 1 Pages / 623.591 x 841.847 pts Page_size
- 41 Downloads / 192 Views
1
S
Ventricular fibrillation: case report A 62-year-old man developed ventricular fibrillation after undergoing dobutamine stress echocardiography as part of an preoperative evaluation. The man, who had a history of type 2 diabetes mellitus, hypertension and hyperlipidaemia, received a dobutamine 40 µg/kg/min infusion with atropine; right knee arthroplasty for severe osteoarthritis was planned. At peak stress, he developed apical regional wall motion abnormality. About 12 minutes into recovery, he developed ventricular tachycardia and subsequently developed ventricular fibrillation. He then became unresponsive. After a precordial thump, the man’s ventricular fibrillation returned to a stable ventricular tachycardia, which was terminated with a 200J shock. Sinus rhythm was subsequently achieved with a BP of 180/100mm Hg. He then received sublingual nitroglycerin [glyceryl trinitrate] followed by a lidocaine infusion. A coronary angiography revealed a 95% distal left anterior descending artery stenosis. He successfully underwent percutaneous coronary intervention and, 1 year later, he successfully underwent right knee arthroplasty. Author comment: "The mechanism of arrhythmia is attributable to the direct adrenergic arrhythmogenic effect of dobutamine through myocardial β-receptor stimulation on the cell membrane." Jiamsripong P, et al. Ventricular fibrillation in late recovery after dobutamine stress echocardiography. Journal of the American Society of Echocardiography 20: 801079216 1220.e7-1220.e10, No. 10, Oct 2007 - USA
0114-9954/10/1174-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 20 Oct 2007 No. 1174
Data Loading...
