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Stress Echocardiography Complication — EECC MCQ

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ModerateGeneral CardiologyStress Echocardiography ComplicationEECC

A 62-year-old man with no prior cardiac history develops chest tightness during a dobutamine stress echocardiogram. The ECG shows 3 mm ST-segment depression in V4-V6. He has new anterolateral wall motion abnormalities. His heart rate is 140 bpm and blood pressure 170/100 mmHg. What is the most appropriate immediate action?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Stop the dobutamine infusion and administer intravenous esmolol

Explanation lettering: D = shown as A · E = shown as D · A = shown as E

This patient has developed significant ischaemia during dobutamine stress echo. The study must be terminated immediately. IV esmolol (a short-acting beta-blocker) reverses dobutamine-induced tachycardia and hypertension and reduces myocardial oxygen demand. Atropine (A) would increase heart rate. Continuing (C) is dangerous. GTN alone (D) does not address tachycardia. Aminophylline (E) is the antidote for adenosine/dipyridamole, not dobutamine.

Reference: BSE (2020): Guidelines for Stress Echocardiography