Volume 29, Issue 2 pp. E39-E42

Beta Adrenergic Receptor Blockade Causing Severe Left Ventricular Systolic Dysfunction during Dobutamine Stress Echocardiography in a Patient with No Structural Heart Disease

David R. Okada B.A.

David R. Okada B.A.

University of Pennsylvania, Philadelphia, Pennsylvania

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Robert D. Okada M.D.

Robert D. Okada M.D.

University of Oklahoma, Oklahoma

University of Tulsa, Tulsa

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Robert O. Bonow M.D.

Robert O. Bonow M.D.

Northwestern University, Chicago, Illinois

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First published: 12 October 2011
Citations: 2
Address for correspondence and reprint requests: Robert D. Okada, M.D., University of Tulsa, 6208 S. Oswego Avenue, Tulsa, OK 74136, USA. Fax: 918-494-3817; E-mail: [email protected]

Abstract

A 41-year-old woman with a history of neurocardiogenic syncope treated with beta-blockers was admitted with chest pain. Dobutamine echocardiogram images demonstrated decreased global LV systolic wall motion and thickening. Coronary angiograms were normal. Beta-blockers were stopped and dobutamine stress echocardiogram (DSE) was repeated. Dobutamine images demonstrated increased global LV systolic wall motion and thickening. Beta-blockers were restarted and again dobutamine produced global LV dysfunction. This case suggests that DSE wall motion response may be falsely abnormal in a patient on beta-blockers. Physicians should be aware of this possibility when interpreting dobutamine echocardiography in patients taking beta-blockers. (Echocardiography 2012;29:E39-E42)

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