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Stress echocardiography: methodology 

Stress echocardiography: methodology
Chapter:
Stress echocardiography: methodology
Author(s):

Maria João Andrade

and Albert Varga

DOI:
10.1093/med/9780198726012.003.0012
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date: 30 March 2020

Stress echocardiography is the combination of echocardiography with a physical, pharmacological, or electrical stress. Good quality images are absolutely necessary and a quad-screen format should be applied for comparative analysis. Different stress echo protocols can be used in different pathologies. Exercise echocardiography has the advantages of its wide availability, low cost, and versatility for the assessment of various cardiac conditions. The most usual pathologies are suspected or known ischaemic heart disease, mitral and aortic valve diseases, hypertrophic cardiomyopathy, and pulmonary hypertension. Among exercise-independent stresses, dobutamine and dipyridamole are the most frequently used. Dobutamine is widely accepted for the evaluation of myocardial viability. The two tests have comparable accuracy for the detection of coronary artery disease. Ergonovine echo is highly feasible, accurate, and safe for the diagnosis of coronary vasospasm. High-rate pacing is especially appropriate in patients with a permanent pacemaker because non-invasive diagnosis of coronary artery disease in these patients is an extremely difficult task.

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