Protocol for dobutamine stress echocardiography

Standard dobutamine infusion protocol for pharmacologic stress testing with echocardiographic imaging. The dobutamine dose is increased every three minutes until the patient achieves at least 85% of maximum predicted heart rate (MPHR). If the heart rate remains <85% MPHR following infusion of dobutamine 40 mcg/kg/min, arm exercise can be performed and/or atropine may be infused in an effort to further increase the heart rate. The echocardiographic images are typically obtained near the end of every three-minute stage, with the peak images obtained at any point once the patient's heart rate exceeds 85% MPHR or the development of symptoms.