Stress Echocardiography

  • Anita Sadeghpour
  • Azin Alizadehasl


Stress echocardiography is done with exercise, administration of a pharmacologic agent, even mental stress, or also transesophageal atrial pacing. The exercise protocol covers a treadmill exercise examination, with fast post-exercise echocardiographic images or upright or supine bicycle echocardiographic images achieved at the peak of exercise. Although exercise-induced regional wall motion abnormality (RWMA) due to ischemia often lasts for a few minutes after the end of the exercise, immediate post-exercise images might be compared with the baseline pre-exercise images to distinguish exercise-induced RWMA. Thus, treadmill exercise with echocardiographic images obtained immediately after the end of exercise is the form of exercise echocardiography used most often to distinguish myocardial ischemia (coronary artery disease).

Vasodilator stress with dipyridamole and pacing stress—via a preexisting permanent pacemaker or a transesophageal pacing catheter—are also likely but less widely used. The examination end point is completed by exercise-limiting symptoms or the completion of the protocol (attainment of at least 85% of the age-predicted maximal heart rate).


Stress echocardiography Regional wall motion abnormality (RWMA) Exercise test in treadmill Dobutamine stress echocardiography (DSE) Myocardial viability Low-flow Low-gradient AS 



Aortic valve area


Dobutamine stress echocardiography




High altitude pulmonary edema


Hypertrophic cardiomyopathy


Intra-ventricular gradients


Mean pressure gradient


Pulmonary artery hypertension


Pulmonary hypertension


Prosthesis/Patient mismatch


Prosthetic valve


Regional wall motion


Regional wall motion abnormality


Stress echocardiography


Systolic pulmonary artery pressure


Stroke volume


Valvular heart disease


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Anita Sadeghpour
    • 2
  • Azin Alizadehasl
    • 1
  1. 1.Professor of CardiologyEchocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical ScienceTehranIran
  2. 2.Associate Professor of Cardiology, Echocardiologist, Echocardiography and Cardiogenetic Research CentersCardio-Oncology Department, Rajaie Cardiovascular Medical and Research CenterTehranIran

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