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Stress Echocardiography: Instructions for Use

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Stress Echocardiography

Abstract

The patient lies in decubitus, the position required to achieve an optimal echocardio-graphic view. Electrocardiographic leads are placed at standard limb and precordial sites, slightly displacing (upward and downward) any leads that may interfere with the chosen acoustic window. A 12-lead ECG is recorded in resting condition and each minute throughout the examination. An ECG lead is also continuously displayed on the echo monitor to provide the operator with a reference for ST segment changes and arrhythmias (Fig.1).

“Stress echocardiography is like sex: if you never done it, you cannot know what it is; once you start, you usually keep on doing it all your life; but if you do it and you don’t find it fun, there is probably something wrong with you.”

Harvey Feigenbaum, verbatim

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References

  1. Popp R, Agatson A, Armstrong W, et al (1998) Recommendations for training in performance and interpretation of stress echocardiography. Committee on Physician Training and Education of the American Society of Echocardiography. J Am Soc Echocardiogr 11:95–96

    Article  PubMed  CAS  Google Scholar 

  2. Picano E, Lattanzi F, Orlandini A, et al (1991) Stress echocardiography and the human factor: the importance of being expert. J Am Coll Cardiol 17:666–669

    Article  PubMed  CAS  Google Scholar 

  3. Hoffmann R, Lethen H, Marwick T, et al (1996) Analysis of interinstitutional observer agreement in interpretation of dobutamine stress echocardiograms. J Am Coll Cardiol 27:330–336

    Article  PubMed  CAS  Google Scholar 

  4. Segali HN (1960) The electrocardiogram and its interpretation: a study of reports by 20 physicians on a set of 100 electrocardiograms. Can Med Assoc 82:2–6

    Google Scholar 

  5. Blackburn H (1968) The exercise electrocardiogram: differences in interpretation. Am J Cardiol 21:871–880

    Article  Google Scholar 

  6. Altwood JE, Jensen D, Froelicher V, et al (1981) Agreement in human interpretation of analog thallium myocardial perfusion images. Circulation 64:601–609

    Article  Google Scholar 

  7. Zir LM, Miller SW, Dinsmore RE, et al (1976) Interobserver variability in coronary angiography. Circulation 53:627–632

    Article  PubMed  CAS  Google Scholar 

  8. Wackers FJT, Bodenheimer M, Fleiss JL, et al (1993) Factors affecting uniformity in interpretation of planar thallium-201 imaging in a multicenter trial. J Am Coll Cardiol 21:1064–1074

    Article  PubMed  CAS  Google Scholar 

  9. Borges AC, Pingitore A, Cordovil A, et al (1995) Heterogeneity of left ventricular regional wall thickening following dobutamine infusion in normal human subjects. Eur Heart J 16:1726–1730

    PubMed  CAS  Google Scholar 

  10. Carstensen S, Ali SM, Stensgaard-Hansen FV, et al (1995) Dobutamine-atropine stress echocardiography in asymptomatic healthy individuals. The relativity of stress-induced hyperkinesia. Circulation 92:3453–3463

    Article  PubMed  CAS  Google Scholar 

  11. Castini D, Gentile F, Ornaghi M, et al (1995) Dobutamine echocardiography: usefulness of digital image processing. Eur Heart J 16:1420–1424

    PubMed  CAS  Google Scholar 

  12. Attenhofer CH, Pellikka PA, Oh JK, et al (1997) Is review of videotape necessary after review of digitized cine-loop images in stress echocardiography? A prospective study in 306 patients. J Am Soc Echocardiogr 10:179–184

    Article  PubMed  CAS  Google Scholar 

  13. Franke A, Hoffmann R, Kuhl HP, et al (2000) Non-contrast second harmonic imaging improves interobserver agreement and accuracy of dobutamine stress echocardiography in patients with impaired image quality. Heart 83:133–140

    Article  PubMed  CAS  Google Scholar 

  14. Zamorano J, Sanchez V, Moreno R et al (2002) Contrast agents provide a faster learning curve in dipyridamole stress echocardiography. Int J Cardiovasc Imaging 18:415–9

    Article  PubMed  Google Scholar 

  15. Varga A, Picano E, Dodi C, et al (1999) Madness and method in stress echo reading. Eur Heart J 20:1271–1275

    Article  PubMed  CAS  Google Scholar 

  16. Hoffmann R, Lethen H, Marwick T, et al (1998) Standardized guidelines for the interpretation of dobutamine echocardiography reduce interinstitutional variance in interpretation. Am J Cardiol 82:1520–1524

    Article  PubMed  CAS  Google Scholar 

  17. Imran M, Palinkas A, Pasanisi E, et al (2002) Optimal reading criteria in stress echocardiography. Am J Cardiol 90:444–445

    Article  PubMed  Google Scholar 

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Picano, E. (2003). Stress Echocardiography: Instructions for Use. In: Stress Echocardiography. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-05096-5_9

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  • DOI: https://doi.org/10.1007/978-3-662-05096-5_9

  • Publisher Name: Springer, Berlin, Heidelberg

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