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A cardiac stress test is a cardiological examination that evaluates the cardiovascular system's response to external stress within a controlled clinical setting. This stress response can be induced through physical exercise (usually a treadmill) or intravenous pharmacological stimulation of heart rate. [1]
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 ...
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]
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]
Echocardiography: A wall motion abnormality at rest which improves during a low-dose dobutamine stress test is classified as "hibernating myocardium." Low dose dobutamine stimulates contractile function and thus helps to predict functional recovery after revascularization.
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]
Low gradient aortic stenosis with concomitant left ventricular dysfunction poses a significant question to the anesthesiologist and the patient. Stress echocardiography (i.e. with dobutamine infusion) can help determine if the ventricle is dysfunctional because of aortic stenosis, or because the myocardium lost its ability to contract. [11]
The Bruce protocol is a standardized diagnostic test used in the evaluation of cardiac function and physical fitness, developed by American cardiologist Robert A. Bruce. [1] ...