ABSTRACT
Stress echo is based upon the principle that an abnormality in myocardial perfusion leads to a change in myocardial function. The principal role of stress echo is in the detection of regional wall motion abnormalities – areas of left ventricular (LV) myocardium that show abnormal function at rest and/or during stress. Patients should receive a clear explanation of what a stress echo study entails and be offered an information leaflet. The key to a successful stress echo study is to obtain clear definition of the LV endocardial border. Exercise stress can be undertaken using either a treadmill or a bicycle: treadmill exercise limits the echo assessment to baseline and peak stress. Vasodilator stress usually causes a relatively small increase in heart rate together with a mild fall in blood pressure. The myocardium can be ‘stressed’ by increasing myocardial oxygen demand, either with physical exercise or pharmacologically using an intravenous infusion of dobutamine.
