Safety of Stress Echocardiography (from the International Stress Echo Complication Registry)

A. Varga, Miguel Angel Rodriguez Garcia, Eugenio Picano

Research output: Contribution to journalArticle

99 Citations (Scopus)

Abstract

The safety of any diagnostic test is a major issue in deciding its practicability and cost-effectiveness. The aim of this study was to evaluate the safety of various stress echocardiographic modalities in the "real world." From February 1998 to January 2004, a simple written questionnaire was distributed to echocardiography laboratories across the world known to perform stress echocardiography. The following categories of major complications (known to occur during stress testing) were indicated: sustained ventricular tachycardia (>30 beats/min), ventricular fibrillation, myocardial infarction, third-degree atrioventricular block, severe hypotension requiring therapy, cardiac asystole, cardiac rupture, stroke, and death. Three hundred centers were polled, from which 71 co-investigators responded and reported on 85,997 patient examinations. Exercise was used in 26,295 cases, dobutamine in 35,103, and dipyridamole in 24,599 cases. Life-threatening events occurred in 86 cases: during exercise in 4 patients (event rate 1 in 6,574), during dobutamine infusion (small dose for viability and/or large dose for ischemia) in 63 patients (event rate 1 in 557), and during dipyridamole stress testing in 19 patients (event rate 1 in 1,294). Of the 86 patients with complications, 5 died during dobutamine stress testing (ventricular fibrillation, n = 2; cardiac rupture, n = 3) and 1 after dipyridamole testing (cardiogenic shock). In conclusion, stress echocardiography is a safe method in the real world, but serious complications may occur. Exercise seems safer than pharmacologic stress and dipyridamole safer than dobutamine, possibly because of preselection criteria.

Original languageEnglish
Pages (from-to)541-543
Number of pages3
JournalThe American journal of cardiology
Volume98
Issue number4
DOIs
Publication statusPublished - Aug 15 2006

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Stress Echocardiography
Dobutamine
Dipyridamole
Registries
Safety
Heart Rupture
Ventricular Fibrillation
Exercise
Cardiogenic Shock
Atrioventricular Block
Ventricular Tachycardia
Heart Arrest
Routine Diagnostic Tests
Hypotension
Cost-Benefit Analysis
Echocardiography
Ischemia
Stroke
Myocardial Infarction
Research Personnel

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Safety of Stress Echocardiography (from the International Stress Echo Complication Registry). / Varga, A.; Garcia, Miguel Angel Rodriguez; Picano, Eugenio.

In: The American journal of cardiology, Vol. 98, No. 4, 15.08.2006, p. 541-543.

Research output: Contribution to journalArticle

Varga, A. ; Garcia, Miguel Angel Rodriguez ; Picano, Eugenio. / Safety of Stress Echocardiography (from the International Stress Echo Complication Registry). In: The American journal of cardiology. 2006 ; Vol. 98, No. 4. pp. 541-543.
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