Pharmacologic Stress Testing



Exercise stress testing is usually the preferred stress testing modality unless the patient is unable to exercise or achieve the target heart rate response or possess contraindications to exercise. Additionally, in the presence of LBBB or ventricular paced rhythm, pharmacological stress testing is the modality of choice. Because the sensitivity of pharmacological stress ECG alone is low, a cardiac imaging modality is needed. Pharmacological stress testing is divided into vasodilator stress with the three available agents: adenosine, dipyridamole, or regadenoson or with a catecholamine, dobutamine.


Pharmacologic stress Adenosine Dipyridamole Regadenoson Dobutamine 


  1. 1.
    Gibbons RJ, et al. ACC/AHA 2002 guideline update for exercise testing: summary article. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to update the 1997 exercise testing guidelines). J Am Coll Cardiol. 2002;40(8):1531–40.CrossRefPubMedGoogle Scholar
  2. 2.
    Henzlova MJ, et al. ASNC imaging guidelines for SPECT nuclear cardiology procedures: stress, protocols, and tracers. J Nucl Cardiol. 2016. doi: 10.1007/s12350-015-0387-x.Google Scholar
  3. 3.
    Gould KL, Lipscomb K, Hamilton GW. Physiologic basis for assessing critical coronary stenosis. Instantaneous flow response and regional distribution during coronary hyperemia as measures of coronary flow reserve. Am J Cardiol. 1974;33(1):87–94.CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag London 2017

Authors and Affiliations

  1. 1.Cardiology DivisionNortheast Cardiology Associates (NECA), Eastern Maine Medical Center (EMMC)BangorUSA
  2. 2.Cardiovascular DivisionUniversity of Miami, Miller School of MedicineMiamiUSA

Personalised recommendations