II. Indications
- Cardiac Screening in patients unable to Exercise 5 Mets
- Intermediate pretest risk of CAD
III. Tests
-
Dobutamine Echocardiogram
- No Beta Blockers for 24 hours before test
- Avoid if very large body habitus (poor echo window)
- Definity or optison contrast can be used to increase accuracy
-
Myocardial Perfusion Imaging with Adenosine (or Regadenoson/Lexiscan)
- Avoid in severe COPD, Asthma, Carotid Stenosis
- No nitrates on day of test
- No Methylxanthines (e.g. Caffeine) for 24 hours prior
-
Myocardial Perfusion Imaging with Dipyridamole
- Uses Dipyridamole (Persantine) instead of Adenosine
- Determine Cardiac Risk pre-major non-cardiac surgery
- May also help with prognosis after major surgery