Table 4.

Checklist for dobutamine stress myocardial test

Pre-procedure	Checked
I. Check for contraindication for dobutamine stress test
1. Severe systemic arterial hypertension (≥220/120 mmHg)
2. Unstable angina
3. High grade aortic stenosis (aortic valve area <1 cm/peak aortic valve gradient >50 mmHg)
4. Uncontrolled or complex cardiac arrhythmias
5. Haemodynamically significant hypertrophic obstructive cardiomyopathy
6. Uncontrolled heart failure
7. Myocarditis, endocarditis and pericarditis
8. History of sudden death
9. Aortic dissection/high grade aortic aneurysm
10. Mobile left ventricular or left atrial thrombus
II. Check list for contraindications for atropine
1. Advance heart block
2. Glaucoma
3. Pyloric stenosis
4. Obstructive uropathy
5. Myasthenia gravis
II. Obtain informed consent
III. Perform pre-procedure 12 leads ECG and review by doctor in charge
IV. Place two angiocatheters intravenously to each arm:
1. One IV 20G in antecubital fossa for contrast
2. One IV 20–22G for adenosine infusion
V. Set up infusion pump for dobutamine infusion:
VI. Additional medication to be ready for use in examination room
1. TNG table
2. Metropolol 5 mg/ml
3. Atropine 0.6 ml × 3 ampules
4. NS flush
During-procedure
1. Oxygen 2 l per nasal cannula
2. Set BP cuff to manual mode. Place BP cuff opposite arm as med administration.
3. Record baseline vital signs- prior to medication administration
4. Record time at the start of dobutmaine infusion. Continue vital sign monitoring whenever change of dosage and prn
Post procedure
1. Perform post stress ECG and review
2. Record total amount of drugs given
3. Record final vital signs prior to discharge. Report any patient complaints to doctor in charge