Complications in stress echocardiography.

The high prevalence of coronary artery disease in western countries has led to the development of non-invasive methods for the detection of myocardial ischemia, notably stress echocardiography (SE). We began our experience in SE in January 1999, 2326 consecutive SE studies being performed up to December 3rd 2001. The mode of stress used was: exercise in 1146 patients (pts); dobutamine in 1117 pts; dipyridamole in 35 pts; permanent pacing in 28 pts; hyperventilation in 4 pts. Eight (0.3%) significant complications occurred during these exams in this period. During exercise stress echocardiography three significant complications occurred: one case of cardiac rupture, one case of sustained ventricular tachycardia and one case of fixed 2nd degree atrioventricular block. In dobutamine stress echocardiography, five significant complications were documented: one case of non-sustained ventricular tachycardia, two cases of sustained ventricular tachycardia and two cases of 2nd degree atrioventricular block. Stress echocardiography is a feasible and safe method for the non-invasive detection of myocardial ischemia, but significant complications may occur and the staff must be prepared to perform immediate cardiopulmonary resuscitation.