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European Journal of Echocardiography Advance Access originally published online on June 13, 2008
European Journal of Echocardiography 2008 9(6):819-821; doi:10.1093/ejechocard/jen180
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Fatal pheochromocytoma crisis precipitated by dobutamine stress echocardiography

Prabhdeep S. Sethi1,*, William Hiser1, Hasan Gaffar2, Leng Jiang1, Ashequl Islam1, Nitin Bhatnagar1 and Mara Slawsky1

1 Department of Cardiology, Baystate Medical Center, 759 Chestnut Street, Springfield, MA 01199, USA
2 Department of Pathology, Baystate Medical Center, 759 Chestnut Street, Springfield, MA 01199, USA

Received 7 April 2008; accepted after revision 18 May 2008; online publish-ahead-of-print 13 June 2008.

* Corresponding author. Tel: +1 4137948722; fax: +1 4137940198. E-mail address: mdheart{at}gmail.com


  Abstract

The safety of dobutamine stress echocardiography (DSE) has been demonstrated in multiple studies with a major complication rate of <1%. Specifically, ventricular tachycardia during DSE has a reported incidence of 0.3%, and has been bound to be of no prognostic significance in patients without obstructive coronary artery disease. We report a unique case of fatal pheochromocytoma crisis precipitated by DSE in a patient with heretofore unknown adrenal disease. We are once again reminded that no diagnostic modality is absolutely without risk; however, minimal they might be.

Keywords: Dobutamine echocardiography; Stress echocardiography; Stress testing; Pheochromocytoma crisis; Ventricular tachycardia


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