Background .– Previous care reports have suggested that dobutamine stress echocardiography may induce coronary artery spasm. The aim of this study was to assess the prevalence of coronary artery spasm during dobutamine stress echocardiography.

Methods .– Over a nine-year period (from November 2001 to October 2010), we reviewed all patients ( n = 2,224) referred for dobutamine stress echocardiography. Criteria for selection included patients aged > 18 years and with dobutamine stress echocardiography. We systematically analysed all ECG performed during dobutamine stress echocardiography, allowing to detect ST elevation during the examination. All patients with ST elevation underwent a coronary angiography.

Results .– A dobutamine stress echocardiography was performed in 2,224 patients. In 20 patients, a ST elevation was observed (always in inferior leads) and all these patients underwent an urgent coronary angiography. In 13 patients (65%), a significant coronary stenosis was observed: ST elevation was observed in case of critical coronary stenosis in six patients and in case of chronic coronary occlusion in seven patients. Finally, seven patients (35% of patients presenting with ST elevation during dobutamine stress echocardiography; six men, mean age: 67 ± 11 years) had no significant coronary stenosis. The prevalence of coronary artery spasm during dobutamine stress echocardiography was 0.3%. In the last patient who presented with this clinical presentation, we induced a coronary artery spasm during coronary angiography with dobutamine perfusion and a second coronary angiography confirmed the diagnosis of coronary spasm after methergin testing.

Conclusion .– Coronary artery spasm during dobutamine stress echocardiography is rare but may occur. Its prevalence is estimated at 0.3%. Physicians should be aware of its presence in dobutamine stress echocardiography.