Assessing the Safety of DSE in Patients With Abdominal Aortic Aneurysm

Complications from dobutamine stress echocardiography (DSE) were found to be rare in patients with abdominal aortic aneurysms > 4 cm, according to a study published in a letter to the editor in the Journal of the American Society of Echocardiography.

With this retrospective review of patient medical records, investigators aimed to determine the safety of DSE in patients with abdominal aortic aneurysm.

Records for 249 patients (26.2% women) with abdominal aortic aneurysm ≥4 cm in diameter (mean diameter, 5.3 cm) who underwent DSE were reviewed for complications which occurred in the next 30 days. Complications examined included rupture, contained rupture, development of symptoms, rapid expansion, and a need for urgent or emergent surgery.

During the 30-day follow-up period, 1 patient experienced complications. The patient presented with an unstable aneurysm (diameter, 8 cm), abdominal pain, and fat stranding detected on computed tomography conducted before DSE. Repeated computed tomography 1 day following DSE showed worsening fat stranding. The patient was discharged with planned outpatient aneurysm repair and died within 3 weeks. 

Another patient had an aneurysm (diameter, 5.2 cm) that ruptured at day 33 post-DSE. The patient was critically ill with disseminated lung adenocarcinoma and cancer-related cachexia.

The researchers noted that the retrospective nature and the small sample size represent limitations of the study.

”A conclusion of safety cannot be made for patients with very large aneurysms, however, given the small number of patients with aneurysm diameter > 7 cm … in our cohort,” noted the study authors.

Reference

Mahmoud O, Patel M, Stanton M, Kochar A, Alsaid A. Safety of dobutamine stress echocardiography in patients with abdominal aortic aneurysm: A single-center 15-year experience [published online May 6, 2020]. J Am Soc Echocardiogr. doi:10.1016/j.echo.2020.03.019