Comparison of Adverse Events
Major Adverse Events With Common Cardiovascular Tests
Procedure | Adverse Event(s) | Risk |
|---|---|---|
Coronary angiography | Death | 1/1,000 |
Dobutamine stress test | MI1, VF2 | 1/2,000 |
Exercise stress test | MI1 or death | 1/2,500 |
SPECT (nuclear) exam or
radionuclide ventriculography | Fatal malignancy | 1/1,000 – 1/10,000 |
Iodinated contrast agents | Life-threatening reactions (potential or immediate) | HO4 – 1/500 LO3 – 1/5,000 |
Ultrasound contrast agents | Anaphylactoid reaction Severe fatal allergic reaction | 1/15,000 1/500,000 |
1MI = myocardial infarct
2VF = ventricular fibrillation
3LO = low-osmolar agents
4HO = high-osmolar agents
“The literature does not support the occurrence of systemic, predictable, adverse events during contrast echocardiography. Consequently, to quote Sherlock Holmes: ‘When you have eliminated the impossible, whatever remains, however improbable, must be the truth.’ Thus, contrary to our fears and against odds, contrast echocardiography appears to be safe in humans. We should use it to improve patient care.”
