Stress echocardiography, or STRES ECHO, is a test used in the diagnosis of, among others, coronary artery disease and valvular heart disease. Its purpose is to determine whether the patient has myocardial ischemia. What is the STRES ECHO test? What is stress echocardiography?

Stress echocardiography( STRESS ECHO ) is a stress echocardiography test that combines two diagnostic methods: exercise electrocardiography (ECG stress test ) and echocardiography (heart echoes).Echocardiographic stress testinvolves the use of various types of tests that stimulate contractility and / or induce controlled hypoxia of the heart muscle with simultaneous echocardiographic assessment of cardiac contractility. Currently, there are 3 variants of stress echocardiography:

  • exercise stress - load the patient with physical effort during the test
  • pharmacological - it consists in administering drugs that increase the demand of the heart muscle for oxygen, such as dobutamine, dipyridamole, adenosine
  • transesophageal - stimulates the heart with a transesophageal electrode

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Stress echocardiography - what is the purpose of the test?

Stress echocardiography provides information, for example, on the extent of myocardial ischemia. In patients after a heart attack, the viability of a specific area of ​​the heart muscle can be assessed, and in patients who have undergone angioplasty, it can be determined how long it will take to restore the heart's systolic function.The echocardiographic stress testalso shows whether a patient with suspected or diagnosed heart disease should undergo coronary angiography or open heart surgery. It can also supplement the results of the ECG stress test.

Stress echocardiography - indications and contraindications

The indication for the examination is the suspicion of coronary artery disease in people who are unable to exercise, abnormal resting ECG that prevents the assessment of ischemia, and qualification for extensive surgery torisk assessment of cardiovascular complications.Echocardiographic stress testcan also be performed when the result of a standard stress test prevents a clear diagnosis.

The test cannot be performed in people who are hypersensitive to the drug or who are struggling with a disease associated with obstruction of the outflow tract from the left ventricle, such as unstable coronary artery disease. Contraindications for stress echocardiography are also: atrial fibrillation, acute phase of myocardial infarction, and septic and cardiogenic shock with blood pressure below 80 mm Hg.

Stress-stress echocardiography

Of all three variants, the most popular is echocardiography combined with exercise in the form of a treadmill or bicycle cycloergometer. The echocardiographic image is recorded before exercise, at rest, at the peak of exercise, and 5-10 minutes after the end of exercise.

CHECK>>What is an exercise ECG?

Stress echocardiography - pharmacological

Another type of test involves the use of pharmacological agents, such as dobutamine or adenosine, in order to make the heart work faster and increase its contractility. The most popular test of this type is thedobutamine test , an echocardiographic stress test using dobutamine - a drug that accelerates the heartbeat by increasing the volume of blood that the heart pushes into the blood vessels in one minute, thus causing a state similar to the state after exercise. During the examination, the patient is gradually administered the drug intravenously with increasing doses, and then, using an echocardiograph, the work of the heart is monitored with its changing load.Dobutamine echocardiographytakes about 30 minutes.

This test can be performed on patients who are unable to exercise.

Stress Echocardiography - Transesophageal

You can also perform a test with transesophageal stimulation. After anesthesia of the back of the pharynx, an esophageal electrode is inserted into the patient's mouth, which is moved forward to a depth of approximately 32-38 cm when swallowed. The electrode is then connected to an electrocardiography (EKG) machine and an external pacemaker. A few minutes of stimulation of the heart and esophagus with a current of 8-25 V and the intensity of 15-25 mA may be perceived by the subject as an unpleasant burning sensation, pain behind the sternum or in the esophagus. Due to the poor tolerance of the test by patients, it is the least frequently performed typestress electrocardiography.

Stress echocardiography - complications

During stress echocardiography, some side effects may appear, indicating that the test should be stopped. These are paresthesia (sensation of body numbness), nausea, palpitations, headaches, shortness of breath, body tremors.

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