2021, Number 4
Cardiovasc Metab Sci 2021; 32 (4)
Cardiac rupture during dobutamine stress echocardiography as stratification after acute myocardial infarction
Silva Ortiz, Josué Alejandro; Mendoza Romo Ramírez, Miguel Ángel
ABSTRACT
Dobutamine stress echocardiography is widely used in stratification after an acute myocardial infarction. Complications that can be life threatening have been reported, ventricular arrhythmias being the most frequent. Cardiac rupture is a rare but fatal complication. We report the case of a 68-year-old male with an inferior infarction without a reperfusion strategy, who underwent a dobutamine stress echocardiogram 6 days after the infarction. During the initial recovery, the patient presented cardiac rupture due to the presence of a pericardial effusion with a hematic appearance and electro-mechanical dissociation. Emergency pericardiocentesis was performed, eventually the patient died. Recent inferior infarction and a dyskinetic zone have been reported in the literature as high-risk characteristics to present. Proper selection of the patient, a baseline echocardiogram without risk characteristics for rupture, and the time to perform the study after the infarction can reduce the incidence of this complication.