CARDIAC STRESS TESTS-IMAGE TESTING

SUMMARY

1. Stress echo & myocardial perfusion imaging (MPI) used for measurement of EF & myocardial viability; provides diagnostic & prognostic information.

2. Indications: in patients unable to exercise adequately, ECG changes at rest that can interfere with interpretation, post-revascularization.

3. Patient can be stressed with exercise (must achieve 85% of predicted HR), dobutamine (inotropic & chronotropic) or vasodilators.

4. Images are obtained while the patient bicycles or within 1-2 min after treadmill exercise.

5. Myocardial contractility normally increases with exercise, whereas ischemia causes hypokinesis, akinesis/dyskinesis of the affected segments.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].