Stress Echocardiography

Abstract

Stress echocardiography is a noninvasive diagnostic method to detect and assess known or suspected coronary artery disease. There are two basic forms of stress echocardiography. One uses a treadmill or an ergometer (upright or supine) to exercise the heart. The other uses various drug agents to simulate exercise. The physician performing the tests and institutional policies will dictate the type of exercise performed and/or the drug agent of choice. The goal is to induce myocardial ischemia by augmentation of oxygen supply to the heart muscle. During the process, electrocardiogram and blood pressure are recorded, and ultrasound images are captured to detect changes in wall motion that may occur. The images are compared with the simultaneously captured electrocardiographic tracings to indirectly assess coronary perfusion to the various segments of the left ventricular myocardium. The purpose of this article is to familiarize the reader with the objectives of stress echocardiography, the needed resources, and the basic protocols for exercise stress echo-cardiography (ESE) and dobutamine stress echocardiography (DSE). Exercise and pharmacologic stress echocardiography are similar in form and function. Except for the actual protocols, information will be presented in combination, with DSE- and ESE-specific information being indicated.