Abstract
Stress echocardiography is an established technique in clinical cardiology for the assessment of patients with known or suspected coronary artery disease.1 It has been shown to be a suitable tool for prognostic purposes in several clinical conditions such as diabetes,2,3 hypertension,4,5 heart failure.6,7 However, there is a wide gap between scientific evidence and guidelines and the clinical use on a routine basis in echocardiographic laboratories. The routine use remains restricted to few laboratories with large volumes and specific expertise, in the face of its low cost (much lower than any other technique for ischemia detection) and the wealth of information it may provide in one sitting. Many reasons have been suggested from a highly specialized personnel to the lack of an objective independent gold standard, the need for a dedicated training and its maintenance over time, the overall volume of each individual laboratory, on top of the familiarity with the different type of stressors …
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