Open AccessUse of dobutamine stress echocardiography for periprocedural evaluation of a case of critical valvular pulmonary stenosis with delayed presentation
Author(s) -
Ramachandra Barik,
Siva Prasad Akula,
Sheshagiri Rao Damera
Publication year - 2016
Publication title -
journal of cardiovascular echography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.255
H-Index - 8
eISSN - 2347-193X
pISSN - 2211-4122
DOI - 10.4103/2211-4122.183758
Subject(s) - medicine , cardiology , ventricle , dobutamine , anasarca , pericardial effusion , tricuspid stenosis , heart failure , stenosis , radiology , hemodynamics
We report a case illustrating a 39-year-old man with delayed presentation of severe pulmonary valve (PV) stenosis, clinical evidence of congestive right heart failure in the form of enlarged liver, raised jugular venous pressure, and anasarca without cyanosis. Echocardiography (echo) was used both for diagnosis and monitoring this patient as main tool. The contractile reserve of the right ventricle (RV) was evaluated by infusion of dobutamine and diuretic for 4 days before pulmonary balloon valvotomy. Both the tricuspid annular peak systolic excursion and diastolic (diastolic anterograde flow through PV) function of RV improved after percutaneous balloon pulmonary valvotomy. These improvements were clinically apparent by complete resolution of anasarca, pericardial effusion, and normalization albumin-globulin ratio. The periprocedural echo findings were quite unique in this illustration.