艾司洛尔诱发的多巴酚丁胺负荷超声心动图后冠状动脉痉挛

Coronary Vasospasm After Dobutamine Stress Echocardiogram Triggered by Esmolol.

作者信息

Manasrah Nouraldeen, Naik Rohan, Al Sbihi Ali F, Afonso Luis C

机构信息

Internal Medicine, Detroit Medical Center/Sinai Grace Hospital, Detroit, USA.

Cardiology, University of Connecticut Health, Farmington, USA.

出版信息

Cureus. 2020 Aug 25;12(8):e10015. doi: 10.7759/cureus.10015.

DOI:10.7759/cureus.10015

PMID:32983711

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7515549/

Abstract

Dobutamine stress echocardiography (DSE) is a commonly utilized method for coronary artery disease (CAD) diagnosis, and it provides important long-term prognostic information. We report a case of a 53-year-old female with multiple cardiovascular risk factors who underwent DSE for evaluation of underlying CAD. The examination was complicated by wide complex tachycardia and promoted administration of esmolol, which shortly led to ST-segment elevation myocardial infarction (STEMI). Coronary angiography showed complete absence of CAD. Coronary vasospasm was a possible suggested mechanism due to the pharmacologic interaction between beta-blockers and dobutamine on alpha- and beta-adrenergic receptors.

摘要

多巴酚丁胺负荷超声心动图（DSE）是一种常用于诊断冠状动脉疾病（CAD）的方法，它能提供重要的长期预后信息。我们报告一例53岁女性病例，该患者有多种心血管危险因素，因评估潜在CAD而行DSE检查。检查过程中出现宽QRS波心动过速，促使使用艾司洛尔，随后不久发生ST段抬高型心肌梗死（STEMI）。冠状动脉造影显示完全没有CAD。由于β受体阻滞剂和多巴酚丁胺对α和β肾上腺素能受体的药理相互作用，冠状动脉痉挛是一种可能的机制。