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The Red Flags of Dobutamine Stress Echo: What Every Echocardiographer Needs to Recognise - Dr Laila Khan

In this practical session, Dr. Khan explores the key red flags encountered during dobutamine stress echocardiography and how to recognise when a study may be becoming unsafe. The presentation reviews expected physiological responses to dobutamine and highlights concerning changes in blood pressure, cardiac rhythm, symptoms, ECG findings, and regional wall motion.

Using practical case examples, Dr. Khan demonstrates how these findings can guide decisions to continue, pause, or terminate a study. The session also emphasises the importance of image quality, careful monitoring throughout recovery, and clear communication between all members of the stress echo team.

Learning Objectives

Recognise key red flags during dobutamine stress echocardiography, including abnormal haemodynamic, ECG, rhythm, symptom, and wall motion responses.
Identify when to pause or terminate a dobutamine stress echocardiogram based on clinical and echocardiographic findings.
Apply effective team communication and escalation strategies to support safe stress echocardiography practice.

Dr Laila Khan

Complete Cardiology, National Capital Private Hospital, Canberra, Australia.

MBBS, MMed (Perioperative Medicine), FRACP Consultant Cardiologist & Echocardiologist | Advanced Cardiac Imaging | Medical Educator

Dr Laila Khan is a Canberra-based consultant cardiologist and echocardiologist with a passion for advanced cardiac imaging, clinical excellence and medical education. She currently practises at Complete Cardiology, National Capital Private Hospital, Canberra, Australia.

She completed her advanced cardiology training at The Prince Charles Hospital in Brisbane, followed by two advanced echocardiography fellowships, where she developed extensive expertise in transthoracic and transoesophageal echocardiography, stress echocardiography and advanced 3D imaging. Her fellowship training included exposure to complex structural heart cases, with a particular focus on imaging assessment and procedural guidance for transcatheter valve interventions.

Dr Khan has a strong clinical interest in valvular heart disease, complex echocardiography and the application of advanced imaging to clinical decision-making. She presented at Sydney Valves in March 2026 and recently co-authored a case report published in the European Heart Journal – Case Reports, titled “Challenging the Limits of Mitral TEER in the Anatomical Red Zone.” This work highlights the importance of advanced imaging, multidisciplinary collaboration and individualised decision-making in challenging mitral valve interventions.

A dedicated educator and mentor, Dr Khan is actively involved in teaching basic physician trainees, advanced cardiology trainees and cardiac sonographers. She contributes to educational initiatives through the Cardiac Society of Australia and New Zealand (CSANZ) and serves as a Clinical Advisor to PiCSA, supporting clinical education, professional development and quality improvement in cardiac care.

Dr Khan is passionate about making echocardiography accessible, engaging and clinically relevant. Through her teaching, she aims to bridge the gap between image acquisition, interpretation and clinical decision-making, empowering clinicians to develop both technical expertise and a deeper understanding of cardiovascular disease.

Her teaching philosophy is simple: Great echocardiography is not just about acquiring beautiful images, but understanding what they mean for the patient.