Stressecho

Stressecho, short for stress echocardiography, is a cardiac imaging test that uses ultrasound to evaluate heart function during stress. It usually begins with a baseline echocardiogram, followed by induced stress either through physical exertion on a treadmill or cycle ergometer, or by pharmacologic agents such as dobutamine, adenosine, or dipyridamole. Images are acquired at rest and at peak stress to detect new or worsening regional wall motion abnormalities, which suggest inducible ischemia. In some protocols, myocardial strain or Doppler measures are also analyzed to quantify function.

Indications include evaluation of suspected coronary artery disease, risk stratification after prior myocardial infarction, assessment of chest pain when noninvasive tests are inconclusive, and evaluation of certain valvular or cardiomyopathic conditions. The test is often used when nuclear perfusion imaging or CT coronary angiography are contraindicated or unavailable.

Advantages: no ionizing radiation (when using standard echocardiography), broad availability, and relatively lower cost. It can be performed at the bedside and provides real-time assessment of cardiac mechanics. Limitations: image quality depends on acoustic windows and patient factors; obesity, chronic lung disease, or chest deformities can reduce accuracy; pharmacologic stress can be contraindicated in some patients; operator experience is important; and multivessel disease can complicate interpretation.

History: Stress echocardiography matured in the late 20th century and has become a standard noninvasive test in cardiology. Modern approaches may incorporate strain imaging for more sensitive detection of subtle dysfunction.