“What is a stress echocardiogram?”

A stress echocardiogram is just one type of stress test. Stress tests are done to evaluate coronary blood flow and muscle function. If a patient has significant atherosclerotic plaque in his coronary arteries (blocking more that 70% of the lumen), a stress test should be abnormal. Stress tests are screening tests designed for high sensitivity (no false negative tests) so a patient with coronary disease doesnt have a normal study. Specificity is less robust, with more false positive tests leading to some unnecessary coronary angiograms. Thats the downside. Each stress type has 2 basic components.. the stressor and the imaging modality used to evaluate the heart response to the stress. The 2 main stress types are exercise (treadmill) or vasodilator administration (regadenosine). The vasodilators mimic exercise for those patients that cannot walk on the treadmill or have certain underlying ECG abnormalities (paced rhythm or left bundle branch block) making the ECG uninterpretable. The imaging components can be treadmill ECG, treadmill echocardiogram or various nuclear imaging types that rely of sophisticated scintillator nuclear cameras. The nuclear images can be very high sensitivity and specificity up to PET-CT (>90%).. exercise is physiologic and preferably used over pharmacological agents (adenosine products). The regular treadmill uses a Bruce protocol, increasing speed and elevation every 3 minutes. Exercise times greater than 9 minutes are good. Greater than 12 are excellent. While exercising the ecg is continuously monitored for changes that indicate ischemia (blocked arteries) and arrhythmias. Also symptoms like chest pain or shortness of breath are noted. The test is done when target heart rate is reached. THR is 220-age x 0.85.. or 85% of maximum heart rate. The sensitivity of a regular treadmill stress test is