II. Background
- Most cost-effective, versatile Cardiac Imaging
III. Indications
- See Exercise Stress Test
- 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. Contraindications
V. Advantages
- Lower cost
- Determines Ejection Fraction
- Can determine ventricular volume
- Assess valvular regurgitation
- Assesses diastolic function
VI. 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
VII. Efficacy
- Stress Echocardiogram
- Test Sensitivity: 64 to 81%
- Test Specificity: 86%
-
Dobutamine Echocardiogram
- Test Sensitivity: >75%
- Test Specificity: >79%
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| Concepts | Therapeutic or Preventive Procedure (T061) |
| CPT | 93351 |
| English | STRESS TTE COMPLETE, Stress tte complete, ECHO TTHRC R-T 2D W/WO M-MODE REST&STRS CONT ECG, Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuous electrocardiographic monitoring, with supervision by a physician or other qualified health care professional |
