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Dobutamine increases cardiac contractility and causes vasodilation with little change in heart rate. It used in the management of acute heart failure with cardiogenic shock or in patients with low blood pressure. It has also been documented for use in the management of chronic heart failure. We reported an 86-year-old man with a refractory heart on long term dobutamine. Case Summary: An 86-year-old retired civil servant living with hypertension for 26 years, type 2 Diabetes Mellitus (T2DM) for 14 years, and hyperlipidemia for 10 years. He was diagnosed with biventricular failure 6 years ago and had cardiac resynchronization therapy (CRT-D) implanted 4 years before the presentation. He presented to the emergency department with 6 weeks history of bilateral leg swelling, dyspnea, orthopnea, paroxysmal nocturnal dyspnea, and oliguria. He has more than 12 repeated hospital admissions for heart failure in the past 4 years despite having CRT-D. He was noted to be anxious and diaphoretic with a respiratory rate of 36 breaths/minute, blood pressure of 84/52 mm Hg, heart rate 80 beats/minute. Peripheral pulses were threatened and diminished in amplitude, and his hands and feet were cool and moist. A summation gallop was noted over the precordium. Fine crepitations were heard over the posterior-basal regions of both lungs. The electrocardiogram showed pacemaker rhythms. He was treated for NYHA class IV heart failure with digoxin, and dobutamine and furosemide. He was discharged home on long term dobutamine infusion. Conclusion: Home dobutamine is a simple and effective in term treatment for end-stage heart failure. Its widespread use may be restricted by cost and expertise considerations in Nigeria *Correspondence to: Edafe Emmanuel Auchi, Department of Internal Medicine, Niger Delta University, Amassoma, Nigeria, E-mail: dremmanueledafe@gmail.com

Long-term home use of dobutamine in end-stage heart failure in nigeria: a case report and review of literatures