Purpose: Transesophageal Dobutamine Stress (TEE-DSE) echocardiography has been reported in small series from few tertiary care instructions. We report on our experience regarding its feasibility in a suburban facility. Methods: From October 1996 to December 1997 TEE-DSE was attempted in 54 patients. Main indication was poor transthoracic echo windows. Dobutamine was infused in increments of 10 mcg/kg to maximum of 40 mcg/kg/min. Atropine IV was used up to 2 mg total dose if desired heart rate (85% of 220 - patient's age) was not achieved. Post-procedure esmolol 0.5 mg/kg was used routinely. Results: Successful TEE-DSE imaging was possible in 53 out of 54 patients attempted (98%). Transesophageal probe insertion was not successful in 1 and 2 subjects did not achieve adequate heart rate. All patients were male, mean age 64.5 +/-10 years and 28 of the 53 (53%) patients with successful imaging were 65 years of age or older. Atropine was used in 13 of the 53 patients (25%). There were no major complications. The most frequent minor complication was throat discomfort. Probe manipulation at each stage was less than 2 minutes to obtain diagnostic quality images in all four views. Conclusions: 1) TEE-DSE can be safely performed in hospitals doing transesophageal echocardiography on a regular basis. 2) It is well tolerated even by elderly subjects. 3) It can be easily employed for stress imaging when nuclear imaging facility is not readily available. 4) The most common complication is throat discomfort and irritation. Clinical Implications: TEE-DSE done by trained cardiologists appears to be feasible as a routine procedure in suburban hospitals.
|Original language||English (US)|
|Issue number||4 SUPPL.|
|State||Published - Oct 1 1998|
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
- Critical Care and Intensive Care Medicine
- Cardiology and Cardiovascular Medicine