Fatal pheochromocytoma crisis precipitated by dobutamine stress echocardiography.

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.

[1]  E. Picano,et al.  Safety of stress echocardiography (from the International Stress Echo Complication Registry). , 2006, The American journal of cardiology.

[2]  P. A. Goldberg,et al.  Hemorrhagic pheochromocytoma associated with systemic corticosteroid therapy and presenting as myocardial infarction with severe hypertension. , 2005, The Journal of clinical endocrinology and metabolism.

[3]  D. Katritsis,et al.  Sustained ventricular tachycardia induced by dobutamine stress echocardiography: a prospective study. , 2005, Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology.

[4]  P. Chaffanjon,et al.  Circumstances of discovery of phaeochromocytoma: a retrospective study of 41 consecutive patients. , 2004, European journal of endocrinology.

[5]  W. Mathias,et al.  Safety of dobutamine-atropine stress echocardiography: A prospective experience of 4,033 consecutive studies. , 1999, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[6]  Jeroen J. Bax,et al.  Safety and utility of atropine addition during dobutamine stress echocardiography for the assessment of viable myocardium in patients with severe left ventricular dysfunction. , 1998, European heart journal.

[7]  M. Fakeeh,et al.  Investigation of phaeochromocytoma. , 1995, Clinical endocrinology.

[8]  E. Picano,et al.  Safety and tolerability of dobutamine-atropine stress echocardiography: a prospective, multicentre study , 1994, The Lancet.

[9]  D. Cameron,et al.  Phaeochromocytoma and cardiomyopathy , 1988, The Medical journal of Australia.

[10]  T. Shaw,et al.  Transient shock and myocardial impairment caused by phaeochromocytoma crisis. , 1987, British heart journal.

[11]  G. Glazer,et al.  Plasma catecholamines in pheochromocytoma: effect of urographic contrast media. , 1984, AJR. American journal of roentgenology.