Case Report

Dobutamine-Induced Complete Heart Block

Authors: Lekshmi Vaidyanathan, MBBS, Nishant Anand, BA, Latha G. Stead, MD, Eric T. Boie, MD, Matthew D. Sztajnkrycer, MD, Deepi G. Goyal, MD

Abstract

Dobutamine is commonly administered as a pharmacologic stressor in patients with limitations precluding exercise testing. The case report presented is one of transient complete heart block resulting from dobutamine sestamibi stress testing. Shortly after initiating the dobutamine infusion, the patient became pale and presyncopal, with hypotension and a heart rate of 50 beats per minute. Subsequently, third-degree heart block developed which lasted transiently and resolved. Subsequent cardiac evaluation of the patient revealed no cardiac etiology for her symptoms. Though bradycardia is infrequently noted in patients receiving dobutamine during stress electrocardiogram, complete heart block is a possibility during dobutamine-induced stress echocardiography and must be recognized as a potential risk.


Key Points


* Bradycardia is infrequently noted in patients receiving dobutamine during stress electrocardiogram (ECG).


* Transient conduction block, atrioventricular block (Mobitz type I and type II) has been reported in dobutamine stress ECG.


* Complete heart block is a possible complication of dobutamine sestamibi stress testing.

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