stress testing

[kamawo]

Anyone involved in stress testing. I work in a cardiology office where the RN's do all the exercise stress tests, and the persantines. Up til now there has always been a physician present during dobutamines. Now we are being told that that is unnecessary. What does anyone else think. Thanx

[jonl]

Kamawo,

I work at the national institutes of health and we generally do the stress test and persantines by ourselves. Our docs usually wont use dobutamine just because it takes to long to get their heart rates up, so not much experience with it. I have used dobutamine infusions in the ed for CHF patients, the once monthly infusions. As long as their monitored we've never had trouble.:)

[kamawo]

thanx, we used dobutamine in cardiac units all the time in the hospital setting, but this is in an office and we have to titrate up to 40mcg/kg. some of the docs even then give atropine after the dobutamine, which has then made us use lopressor to get their heart rates back down. In the echo lab you can see the results of the dobutamine long before their heart rates go up, so depending on the doc, we may stop at peak if pictures are good. Just too many possible side effects at peak doses!

[kamawo]

thanx, we used dobutamine in cardiac units all the time in the hospital setting, but this is in an office and we have to titrate up to 40mcg/kg. some of the docs even then give atropine after the dobutamine, which has then made us use lopressor to get their heart rates back down. In the echo lab you can see the results of the dobutamine long before their heart rates go up, so depending on the doc, we may stop at peak if pictures are good. Just too many possible side effects at peak doses!

[jonl]

Kamawo,

Sure sounds like to many side effects. Why don't you use persantine or the treadmill, less side effects and probably a better picture?

[jonl]

Kamawo,

Sure sounds like to many side effects. Why don't you use persantine or the treadmill, less side effects and probably a better picture?