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Perfusion stress test (with 99mTc labelled sestamibi [15]) is appropriate for select patients, especially those with an abnormal resting electrocardiogram. Intracoronary ultrasound or angiogram can provide more information but is invasive and carries the risk of complications associated with cardiac catheterization procedures.
The majority of scans are performed using a stress/rest protocol using adenosine as the stressor which acts to induce ischaemia in the myocardium by the coronary 'steal' phenomenon. Some centers use inotrope dobutamine to stress the heart and the images are interpreted in a similar fashion to dobutamine stress echocardiogram. This article ...
These abnormalities can be visualised with echocardiography, cardiac magnetic resonance imaging (CMR), nuclear medicine (PET) or ventriculography. Echocardiography: A wall motion abnormality at rest which improves during a low-dose dobutamine stress test is classified as "hibernating myocardium."
Strain rate imaging during stress has been shown to give incremental value over ordinary echocardiography, both diagnostic [28] [29] and prognostic. [30] In stress echo, the increased heart rate has speckle tracking at a disadvantage, due to the limited frame rate that affects tracking at higher heart rates. [citation needed]
Dobutamine is a medication used in the treatment of cardiogenic shock (as a result of inadequate tissue perfusion) and severe heart failure. [2] [3] It may also be used in certain types of cardiac stress tests. [2] It is given by IV only, as an injection into a vein or intraosseous as a continuous infusion. [2]
Stress echocardiography is very commonly used in assessing for ischemia resulting from coronary artery disease. It can be performed exercising, preferably with a bicycle that allows the patient to exercise while lying flat, which allows for imaging throughout the entire testing period. [ 33 ]
The X-ray came back clear, and the doctor suggested the pain may be psychosomatic, brought on by stress. "Okay, sure," I thought. I was 18 and had no experience with the medical world — I didn ...
Tests include coronary angiography, intravascular ultrasound, dobutamine stress echocardiography, positron emission tomography, computed tomographic angiography (CT angiography) and several biomarkers. [2] Statins and aspirin are commenced early after transplantation and on detection of CAV. [2]