Role of stress echocardiography in the assessment of myocardial ischemia

Author(s): Patel Dhwani Manishbhai, Gulam Husain Nabi Husain Mahato, Ronak Brijeshkumar Upadhyay, Abhimanyu Agarwal, Binay K Panjiyar, Monica Ghotra

Stress Echocardiography (ECG) is a commonly used modality for detection and assessment of Ischemic Heart Diseases (IHD). Its non-invasive nature makes it a more reliable diagnostic tool. This modality induces myocardial stress through exercise or pharmacological agents. Stress Echocardiography induced by exercise stress tests are more physiologic than pharmacologic stress tests as its finding tells about a patient’s exercise capacity which is prognostically important. Thus, if a patient can exercise, this is the preferred stress modality. Moreover, its radiation-free nature makes it a preferred option for individuals with contraindications to other stress imaging techniques and also decreases complications associated with other cardiac imaging modalities. Clinical conditions can be accurately assessed by comparing the findings of the heart rate and electrocardiograms after stress echocardiography with normal state. Analysis of stress echocardiography is done by visual precise evaluation of impaired myocardial contractility and regional wall motion abnormalities. This modality shows excellent results with current technology and by using an image enhancing agent, where necessary. It can identify the location of myocardial ischemia as well. Stress echocardiography holds significant potential in changing outcomes for a large population of patients with its high diagnostic accuracy, risk stratification capabilities, and cost-effectiveness.