stress echocardiography

Indications

• uninterpretable ECG stress testing
• information about a particular region of myocardium at risk is needed
• normal ECG stress testing with high index of suspicion for coronary artery disease

Clinical significance

• in patients with significant coronary artery disease (CAD), stress induces segmental wall motion abnormalities in the region of distribution of the diseased vessels
• left ventricular dilatation occurs when large areas are involved
• myocardial viability may be determined by identifying increased wall motion in myocardial segments akinetic at baseline, for example increased LV ejection fraction with dobutamine infusion
• cardiac valve function can be assessed
• pulmonary pressures may be assessed

Sensitivity for detecting coronary stenosis of 50-70% is:

• 70-80% for single vessel disease
• > 90% for left main & 3 vessel coronary artery disease

Procedure

• exercise or dobutamine stress used in connection with echocardiography in the evaluation of heart motion in patients with suspected coronary artery disease
• study completed in < 1 hour

Notes

• image quality may be suboptimal in some patients but can be improved using microbubble transpulmonary contrast

More general terms

• echocardiography
• cardiac stress testing

More specific terms

• dobutamine stress echocardiography
• exercise stress echocardiography

Additional terms

• coronary artery disease; coronary atherosclerosis (CAD)