II. Background
- Most cost-effective, versatile Cardiac Imaging
III. Indications
- Chest Pain Evaluation if no suspected Aortic Dissection
- Nondiagnostic Stress EKG, Intermediate CAD likelihood
- Resting ST-T Wave abnormalities
- Left Bundle Branch Block
- Ventricular paced rhythm
- Left Ventricular Hypertrophy
- Digoxin treatment
- CAD Diagnosis, risk stratification, and therapy
- Assessment of left ventricular systolic function
- Identify lesions in planning for PTCA intervention
- Risk stratification prior to noncardiac surgery
IV. Advantages
- Lower cost
- Determines Ejection Fraction
- Can determine ventricular volume
- Assess valvular regurgitation
- Assesses diastolic function
V. Disadvantages
- Operator dependent
- Large body habitus interferes with echo windows
- Definitiy (Perflutren Lipid Microsphere) or optison contrast can be used to increase accuracy
- Lower Test Sensitivity for ischemia
- More than 20% of Myocardium must be ischemic to demonstrate a wall motion abnormality
VI. Efficacy
- Stress Echocardiogram
- Test Sensitivity: 81%
- Test Specificity: 86%
-
Dobutamine Echocardiogram
- Test Sensitivity: >75%
- Test Specificity: >79%