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exercise stress echocardiography

Indications: - suspected of coronary artery disease - recommended when baseline ECG is abnormal* or when information on the area of myocardium at risk is needed - can can identify asymptomatic patients at high risk after revascularization - these patients do not necessarily benefit from repeat revascularization [2] * left-bundle branch block acceptable for exercise stress echocardiography [3] Advantages: 1) exercise data are acquired along with imaging for wall motion abnormalities that indicate ischemia 2) entire study is complete in < 1 hour Disadvantages: - image quality is suboptimal in some patients but can be improved by use of echo-contrast Notes: - a wearable device consisting of an 8 uM stretchable strip of sensors applied to the chest to obtain continuous cardiac ultrasound images can facilitate obtaining ultrasound images during exercise including real-time estimates of stroke volume, cardiac output, ejection fraction, wall-motion abnormalities, & chamber size [4]

General

exercise stress testing stress echocardiography

References

  1. Medical Knowledge Self Assessment Program (MKSAP) 15, 18. American College of Physicians, Philadelphia 2009, 2018.
  2. Harb SC et al Exercise Testing in Asymptomatic Patients After Revascularization: Are Outcomes Altered? Arch Intern Med. 2012;():1-8 PMID: 22905351 http://archinte.jamanetwork.com/article.aspx?articleid=1151706
  3. Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022
  4. Hu H, Huang H, Li M et al. A wearable cardiac ultrasound imager. Nature 2023 Jan; 613:667. PMID: 36697864 PMCID: PMC9876798 Free PMC article https://www.nature.com/articles/s41586-022-05498-z