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Stress Echocardiography pp 585–609Cite as

Stress Echocardiography in Valvular Heart Disease

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Abstract

Major advances in diagnosis and risk stratification, combined with enormous progress in surgical valve replacement and repair, have led to improved outcomes of patients with valvular heart disease over the past 30 years. The most important indication for surgical intervention in patients with hemodynamically significant aortic or mitral valve disease is the development of symptoms, as emphasized in recent guidelines [1–3]. As symptoms may develop slowly and indolently in these chronic conditions, many patients are unaware of subtle changes in effort tolerance, even when questioned directly by their physicians. Hence, recent guidelines of both the American College of Cardiology/American Heart Association (ACC/AHA) and the European Society of Cardiology (ESC) [2, 3] have placed renewed emphasis on the role of exercise testing to provide objective evidence of exercise capacity and symptom status. In addition, while Doppler echocardiography is the method of choice for assessing severity of valvular disease, there is a growing utilization of stress two-dimensional and Doppler echocardiography to assess dynamic changes in hemodynamics in concert with the clinical findings of exercise testing.

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Authors and Affiliations

  1. Department of Cardiology, GIGA Cardiovascular Sciences Heart Valve Clinic, University Hospital, CHU Sart Tilman, Liege, Belgium

    Patrizio Lancellotti MD, PhD

  2. Québec Heart Institute, Laval Hospital Research Center, Québec City, QC, Canada

    Philippe Pibarot PhD, DSci, FACC

  3. Heart Institute, Canada Research in Valvular Heart Diseases, Faculty of Medicine, Laval University, Québec City, QC, Canada

    Philippe Pibarot PhD, DSci, FACC

  4. CNR Pisa, Ist. Fisiologia Clinica, Via Moruzzi 1, Pisa, 56124, Italy

    Eugenio Picano MD, PhD

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  2. Philippe Pibarot PhD, DSci, FACC
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  3. Eugenio Picano MD, PhD
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Table of Contents Video Companion

Table of Contents Video Companion

  • See illustrative cases number 32, 33, 34, and 35 (aortic stenosis with low-flow, low-gradient, and reduced ejection fraction) by Maria Joao Andrade, MD, Carnaxide, Lisbon, Portugal

  • See also, in the section Nuovo Cinema Paradiso remastered, the short movie: The Rocky Horror Stress echo picture show (with a complicated stress echo case in a patient with aortic stenosis).

  • Springer Extra Materials available at http://extras.springer.com/2015/978-3-319-20957-9

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Lancellotti, P., Pibarot, P., Picano, E. (2015). Stress Echocardiography in Valvular Heart Disease. In: Stress Echocardiography. Springer, Cham. https://doi.org/10.1007/978-3-319-20958-6_36

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