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European Heart Journal 1992 13(7):997-999;
Copyright © 1992 by the European Society of Cardiology.
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© 1992 The European Society of Cardiology

Dobutamine-induced ST segment elevation in a patient with angina at rest and critical coronary lesions

M. PREVTTALI, L. LANZARINI, A. MUSSINT, M. FERRARIO, L. ANGOLI and G. SPECCHIA

Division of Cardiology, IRCCS-Policlinico S.Matteo, Department of Internal Medicine, Section of Cardiology, University of Pavia Pavia, Italy

Received 16 July 1991; revised 18 November 1991; .

Correspondence: M. Previtah, Division of Cardiology, IRCCS-Policlinico S.Matteo, Piazza Golgi, 1, 27100 Pavia, Italy.

Abstract

A case of dobutamine-induced ST-segment elevation in a patient with angina at rest and severe two-vessel disease is described. Coronary angiography performed during the ischaemic episode showed patency of coronary arteries; ST-segment elevation and chest pain regressed after propranolol administration. This case suggests that in the presence of severe coronary lesions dobutamine may produce transmural myocardial ischaemia by increasing myocardial oxygen demand and inducing myocardial blood flow maldistribution.

Key Words: Dobutamine • angina pectoris • ST-segment elevation


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