What are the applications for stress echocardiography? How is it performed?

Stress echocardiography is an important imaging technique for evaluating ventricular function, global ejection fraction, regional wall motion, and myocardial thickening and for assessing hemodynamic or cardiac function at baseline as well as at maximal stress or point of symptoms. Among the most common clinical applications is hemodynamic assessment of mitral stenosis in symptomatic patients in whom resting hemodynamic status is insufficient for a clinical decision. In addition, other dynamic lesions are better assessed with stress, including hypertrophic cardiomyopathy, recoarctation of the aorta, and dysfunction of prosthetic valves. The most common use is diagnosis of ischemic heart disease with a pre- and intermediate post-exercise echocardiography to evaluate wall motion. The test is relatively inexpensive and is as sensitive and specific as single-photon emission computed tomography (SPECT) with thallium during exercise for assessment of ischemic heart disease. For patients who cannot do conventional treadmill stress tests, dobutamine or dipyridamole can be used.

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