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Stress echocardiography: diagnostic criteria and interpretation 

Stress echocardiography: diagnostic criteria and interpretation
Chapter:
Stress echocardiography: diagnostic criteria and interpretation
Author(s):

Paolo Colonna

, Monica Alcantara

, and Katsu Tanaka

DOI:
10.1093/med/9780198726012.003.0014
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date: 05 April 2020

This chapter discusses the diagnosis and interpretation of stress echocardiography, which needs a careful side-by-side analysis of each myocardial segment. The first step is the accurate analysis of regional wall motion at rest with particular attention on hypokinetic segments. In the second step, after a global evaluation of stress images, all segments should be carefully analysed for the presence of reduced wall thickening or delayed contraction compared to rest, preferably with a quad screen analysis. Particular attention has to be placed on assessment of wall thickening rather than wall motion or endocardial excursion as these may result from tethering of neighbouring segments or translational movement of the heart. The wall motion response to stress can be schematized based on the changes that occur during low stress and high stress, compared to rest baseline.

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