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Unexpected outcome (positive or negative) including adverse drug reactions
CASE REPORT
Dobutamine stress echocardiogram-related in-stent thrombosis with acute myocardial infarction
  1. Puneet Gupta1 and
  2. Anand Chockalingam2
  1. 1 Division of Cardiovascular Medicine, University of Missouri Health Care, Columbia, Missouri, USA
  2. 2 Division of Cardiovascular Medicine, University of Missouri Health Care, Columbia, Missouri, USA
  1. Correspondence to Dr Puneet Gupta, puneetgupta1109{at}gmail.com

Abstract

Dobutamine stress echocardiogram (DSE) is considered a safe and reliable method for screening for underlying myocardial ischaemia. We report a case of a 60-year-old man who developed inferior ST-segment elevation myocardial infarction within 30 minutes of a normal DSE. The patient was found to have a 99% in-stent restenosis in the mid-right coronary artery with significant thrombosis for which successful percutaneous coronary intervention (PCI) was performed. Acute coronary syndrome after a normal DSE has been rarely reported in the literature. The reported cases were found to have obstructive or non-obstructive coronary plaques with overlying thrombus, which suggests plaque destabilisation and rupture as the possible underlying mechanism behind coronary occlusion.

  • ischaemic jeart disease
  • interventional cardiology

https://doi.org/10.1136/bcr-2018-228080

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    Footnotes

    • Contributors PKG was involved in planning, writing and revising all sections of the article, interpretations of the tests and collecting information and data of all relevant portions of the case. AC was involved in editing/reviewing/revising all sections of the article, interpretations of the images of DSE and ECG as well as the conception of the article.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.