[Echocardiography under perfusion with dobutamine. Experience of Tunisian cardiologic service about 70 cases]

We report a prospective study which began on February 1[st], 1999. 70 consecutive and non selected patients got an dobutamine stress echocardiography. The major indication, in 53% of cases, was detection of coronary disease in patients suffering from chest pain but whose stress testing were not conclusive. Dobutamin was continuously and intraveinously administered at doses ranging from 5 to 40 microg. Maximal dose was obtained in 73% of cases. The most frequent reason that led us to stop the test was the reach of the target cardiac frequency [85 of FMT]. We observed 7 severe rythmic complications [2 auricular fibrillation, 1 flutter, 2 episodes of frequent and polymorphic ESV, 2 TVNS]. One patient presented a myocardial infarction during dobutamin echography whereas the basic kinetics was normal. 26 patients got a coronarography within 3 days following echography. Stress echography detected a significant coronary stenosis [ >/= 50%], with a sensitivity of 86%, a specificity of 83% and a precision in the diagnosis of 84%

[Hypertrophic cardiomyopathy and pregnancy]

We report the case of a 32 years old patient, with a known diagnostic of hypertrophic cardiomyopathy; who has presented at the first trimester of pregnancy a ventricular fibrillation treated by electric shock with a favorable outcome. The risks for the mother and the fetus are discussed; The recommendations for the conduct of the delivery are reviewed