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Neuropsychiatric Symptoms During 24 Hours after Dobutamine-Atropine Stress Testing: A Prospective Study in 1,006 Patients
Journal of the American Society of Echocardiography
Issue: Volume 24(4), April 2011, p 367–373
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Results: A total of 1,006 patients were included (mean age, 67 ± 12 years; 462 [46%] women). Of the 750 patients who returned questionnaires, 53 patients (7.1%) reported NP symptoms. Among the 199 controls, three patients (1.5%) reported NP symptoms. Symptoms were usually mild and resolved spontaneously. Independent predictors of NP symptoms were atropine dose >= 1 mg (odds ratio [OR], 7.69; 95% confidence interval [CI], 4.13–14.81), prior NP disorder (OR, 2.11; 95% CI, 1.11–4.02), positive Delirium Observation Screening Scale result (OR, 4.89; 95% CI, 1.21–18.09), and body mass index < 24 kg/m2 (OR, 2.37; 95% CI, 1.10–4.90). Conclusions: Although usually mild, NP symptoms were nearly fivefold more common after DST (P < .001). Patients who had received >= 1 mg atropine and those with underlying NP disease, positive Delirium Observation Screening Scale results, or lower body mass indexes are at increased risk.
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Curioso estudo aponta para outros efeitos não desejados do stress farmacológico.
Mas não são suficientes para contraindicar o método em pacientes que não podem ou não conseguem realizar a modalidade com esforço...
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Os "sintomas psiquiátricos" iniciam-se na sala do teste devido a grande espectativa gerado pelo método, mal orientação e condução do ecocardiografista. Temos que gastar 3 a 5 minutos explicando o método e sua segurança juntamente com o seu consentimento informado. Assim não haverá tais sintomas pós teste!!!
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