Acute myocardial infarction after a negative Dobutamine stress echocardiogram in a patient with end-stage liver disease

Authors

  • Khursheed Ahmad Department of Cardiology, Punjab Institute of Cardiology, Lahore, Pakistan
  • Khurram Shahzad Department of Cardiology, Punjab Institute of Cardiology, Lahore, Pakistan
  • Muhammad Muzaffar Mahmood Department of Cardiology, Ittefaq Hospital, Lahore, Pakistan

DOI:

https://doi.org/10.47391/JPMA.5498

Abstract

Dobutamine stress echocardiogram (DSE) is generally a safe and reliable test for detection of myocardial ischaemia. We report the case of a 43-year-old male with end-stage liver disease (ESLD), who underwent DSE as part of workup for liver transplantation. Although the patient had an uneventful negative DSE, within 45 minutes he developed inferior ST-segment elevation myocardial infarction (STEMI). His coronary angiography showed severe 2-vessel coronary artery disease, which was treated with percutaneous coronary intervention (PCI) with implantation of drug-eluting stents (DES). Acute coronary syndrome (ACS) after a normal DSE has previously been reported in the literature. We describe one such case, with added complexity of managing an ACS in a patient with high bleeding risk. Our case is unique in reporting a STEMI after a negative DSE in a liver transplant recipient. Increased physician awareness of potential complications of DSE is essential to allow timely recognition and management.

Published

2023-03-15

How to Cite

Ahmad, K., Shahzad, K., & Muhammad Muzaffar Mahmood. (2023). Acute myocardial infarction after a negative Dobutamine stress echocardiogram in a patient with end-stage liver disease. Journal of the Pakistan Medical Association, 73(4), 905–907. https://doi.org/10.47391/JPMA.5498

Issue

Section

Case Report