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.”

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