Stress Echocardiography Its Principles and Practical Aspects

STRESS ECHOCARDIOGRAPHY HAS EMERGED as an important imaging modality for the evaluation of patients with coronary artery disease (CAD). The rationale for using stress echocardiography stems' from the fact that CAD cannot always be confirmed or ruled out on the basis of symptoms and/or ECG fmdings alone. Moreover, stress echocardiography provides additional information on the cardiac mechanical pump function which is an important parameter that helps the clinician to determine prognosis in patients with ischemic heart disease. Irrespective of the cause, myocardial ischemia in a single coronary territory is associated with three clinical manifestations: abnormal regional left ventricular function, ECG changes, and angina. Experimental and clinical experience suggests that regional wall motion abnormalities may precede both angina and the ECG changes. 1-5 The loss of normal contractile activity in a vascular bed results early and rapidly in asynergy, which is detectable by echocardiography.6