Though theoratically threre is chance of rupture of AAA during dobutamine stress echocardiography,one nice study publised in Am J of Cardiology in 1966 by Tajik et al showed it it can be safely perfomed in patients of AAA more than 4cm.However I think  it should be better avioded in symptomatic patients and when AAA size more than 5.5cm.If systolic BP became more than 180mm,test should be stopped.I think CT coronary angiography along with CT aortography would be better than these nonivasive tests for cardiac evaluation in patients with AAA.Patient with family history of AAA and patients with rapid increase in size of AAA shouil better be avoided dobutamine stress echo.   

Thank you Dr. Majumder,

I'm inclined to agree. Consideration should be given to alternative cardiac evaluation options, unless otherwise contraindicated.  

Quite a few factors to consider--including AAA sizes > 6 cm and blood pressure.  I've seen blood pressure responses to Dobutamine range between 60 mmHg and as high as 200 mmHg. For some patients, beta blockers are held prior to Dobutamine stress echo. It is not always easy to predict BP responses.  

Hello Deborah Darlene Williams

Thank you for setting up this question. It is funny that I did not discover it until five years after you first asked it here! My attitude has oscillated over this time and now I am more agreed with your conclusion. I thank Biswajit Majumder for pointing to an evidence-based response. I wonder if Asif Machhada alsoAsif Machhada has supportive literature as this is somewhat different to my anecodtal experience.

Interesting also that Lexiscan/regadenoson is not available in some parts of the world, still. I presume it applies equally to other vasodilator testing such as with adenosine and dipyridamole.