The dynamic echocardiographic study (stress echo) is a modern diagnostic test carried out by a specialized cardiologist. It is mainly used to identify significant narrowings in the coronary vessels of the heart (coronary disease).
How is it?
The examination is carried out in special centers, such as Therapis General Hospital, by specialized staff with extensive experience and special state-of-the-art equipment. This aims not only at the reliability of the examination but also at the safety of the patient during it.
The loading techniques used are either exercise (bicycle, treadmill) or, more commonly, pharmaceutical (usually with dobutamine, dobutamine stress test). The cardiologist takes ultrasound video images at various stages as the heart rate increases while the electrocardiogram and blood pressure are recorded. Upon stopping the drug, heart rates return to normal after a few minutes. After the examination, the patient returns to his usual activities.
The patient is instructed to fast for approximately 2 hours, and upon consultation with the physician, may need to discontinue some medication (such as beta-blockers).
What are its advantages?
- It is carried out using ultrasound (does not involve radiation)
- Duration is short (15-30 minutes)
- It can also be applied to people who cannot exercise.
- It has higher diagnostic accuracy than the simple fatigue test (about 90%) since the doctor, in addition to the electrocardiogram, monitors the changes in the heart’s contractility (wall mobility) through ultrasound. So, it tends to replace the simple fatigue test.
- Results are obtained instantly. The patient is informed of pathological findings, and further treatment is decided, either with drugs or invasively with coronary angiography.
Penelope Rafouli-Stergiou, MD, PhD – Director of Cardiology Department Therapies General Hospital
Which people are recommended to have a stress echo?
- Patients who are under a risk factor regarding coronary heart disease (such as smoking, heredity, arterial hypertension, diabetes mellitus, dyslipidemia, obesity, metabolic syndrome)
- Patients with symptoms such as chest pain (chest pain), shortness of breath, or easy fatigue (as long as acute myocardial infarction is ruled out)
- Patients with other symptoms, such as syncope or complex arrhythmias and the possibility of coronary heart disease
- Patients with equivocal results of other diagnostic tests for coronary artery disease, such as stress test, cardiac scintigraphy, CT angiography – calcium score)
- Patients before an operation in non-cardiac surgery, to assess the cardiovascular risk during surgery.
- Patients have already been diagnosed with coronary artery disease (previous myocardial infarction, angioplasty-stent, or coronary artery bypass graft-CABG) to assess the effect of surgery and medication or to diagnose new narrowings in the coronary vessels or grafts, to assess the viability of the affected part of the heart, and the more general functionality of the heart.
- Patients who have shown heart failure, to clarify whether it is due to coronary (ischemic) disease in the event that the patient is not going to undergo coronary angiography
- Patients with valve diseases (e.g. aortic stenosis, mitral insufficiency) to better assess the severity of the disease and the symptoms that cause fatigue, in order to guide possible invasive treatment.
In conclusion, stress echo, is the most established, reliable, non-invasive test for diagnosing mainly coronary heart disease but also other heart diseases with great safety and efficiency.
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