[How to do a stress echocardiography?]

Dtsch Med Wochenschr. 2015 Jun;140(13):992-6. doi: 10.1055/s-0041-102574. Epub 2015 Jun 26.
[Article in German]

Abstract

Stress echocardiography (SE) is a powerful functional imaging technique to assess cardiac performance under work conditions. The main indication is the detection of myocardial ischemia due to coronary artery disease (CAD), however it can also be used in patients with structural heart disease (e. g. valvular disease, hypertrophic obstructive cardiomyopathy). Dynamic or pharmacological (dobutamine / adenosine) modalities are available to induce cardiac stress, basically depending on the clinical problem and the patient's ability to exercise. Exercise on a treadmill or a semi-supine bicycle is the most physiological way to induce stress. Dobutamine stimulation is useful in patients who are unable to exercise and for detection of viable myocardium in hypo- or akinetic segments. Adenosin-induced hyperaemia causes steal effects in myocardial segments with significant CAD. Main limitations of SE are the need for an appropriate acoustic window and the user-dependent variability with regard to the interpretation of the results.

MeSH terms

  • Adenosine
  • Cardiomyopathy, Hypertrophic
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / physiopathology
  • Coronary Circulation / physiology
  • Dobutamine
  • Echocardiography, Stress / methods*
  • Heart Diseases / diagnostic imaging*
  • Heart Diseases / physiopathology*
  • Heart Valve Diseases / diagnostic imaging
  • Heart Valve Diseases / physiopathology
  • Humans
  • Myocardial Ischemia / diagnostic imaging
  • Myocardial Ischemia / physiopathology

Substances

  • Dobutamine
  • Adenosine