A New Stress for Stress Tests

To the Editor: A 71-year-old man was recently referred to our echocardiography laboratory for a stress test with dobutamine. Initially, he appeared to be a calm, soft-spoken man. His resting heart rate was 81 beats per minute. During the first dose of dobutamine (5 μg per kilogram of body weight per minute), his base-line heart rate was 92 beats per minute. He then engaged one of the physicians in a discussion about Hillary Clinton and the Clinton administration's proposed health care reform. It was clear from the conversation that the patient was strongly opposed to it. While he was talking…