Echocardiogram
and other bedside ultrasound diagnostics
Procedure description
A stress test may be accompanied by a stress echocardiogram. The echocardiography is performed both before and after the exercise so that structural differences can be compared. It allows your doctor to test how your heart performs under stress.
A resting echocardiogram is obtained prior to stress. The images obtained are similar to the ones obtained during a full surface echocardiogram, commonly referred to as transthoracic echocardiogram. The patient is subjected to stress in the form of exercise or chemically (usually dobutamine). After the target heart rate is achieved, 'stress' echocardiogram images are obtained. The two echocardiogram images are then compared to assess for any abnormalities in wall motion of the heart and to detect obstructive coronary artery disease.
A well-recognized sequence of events is precipitated by an imbalance between myocardial oxygen supply and demand This sequence helps explain why measures of ischemia obtained with echocardiographic or radionuclide imaging are more sensitive indicators than ECG measures; they occur at a lower intensity of ischemia, and thereby precede ECG changes. Similarly, silent ischemia that is identified electrocardiographically often occurs at a lower ischemic threshold than that needed for the symptomatic expression of ischemia.
The doctor may order a stress echocardiogram for several reasons. For example, the patient may have an irregular heartbeat abnormality during 24 hours Holter monitoring, or the doctor wants to inspect the heart valves and chambers functions during the stress. They may also order one if you're showing signs of heart problems, such as chest pain or shortness of breath during the stress.
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