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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.
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."
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]
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]
Apical four chamber ultrasound view of heart. Transthoracic echocardiography (TTE) uses ultrasonic waves for continuous heart chamber and blood movement visualization. It is the most commonly used imaging tool for diagnosing heart problems, as it allows non-invasive visualization of the heart and the blood flow through the heart, using a technique known as Doppler.
Focused assessment with sonography in trauma (commonly abbreviated as FAST) is a rapid bedside ultrasound examination performed by surgeons, emergency physicians, and paramedics as a screening test for blood around the heart (pericardial effusion) or abdominal organs (hemoperitoneum) after trauma.
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 ]
In order to listen to the lungs from the back the patient is asked to move their arms forward to prevent the scapulae (shoulder blades) from obstructing the upper lung fields. These fields are intended to correlate with the lung lobes and are thus tested on the anterior (front) and posterior (back) chest walls.