ECHO- Stress Echocardiography Flashcards
T/F? The sub-endocardium contributes proportionally more to total systolic thickening than the sub-epicardium
true
stress echo has same sensitivity with nuclear perfusion about 88%. T/F?
True
T/F? A normal exercise echo is associated with cardiac death or non-fatal Mi rate of 0.5% per person-year follow up
TRUE, normal DSE has 1-2%
T/F? increase WMSI is associated with increase cardiac event
True!
Indication for Stress echo
see pic.
Contraindications for Stress echo
see pic
Modalities of Stress echocardiography
There are 3.
Procedure during Stress echo
Baseline->Exercise->Recovery
Dobutamine protocol, viability vs DSE?
lower dose for viability test
Flow in DSE
see pic
What is the normal global response to stress? in stress echo
increase LVEF, decrease LVESV
What is the normal regional response to stress? in stress echo
no resting regional wall motion abnormalities, increase regional wall thickening with stress
Mechanism of Dobutamine Viability Study
viable - if there is increase RWM with low dose dobu
What are the positive for ischemia in stress echo?
see pic
What are the normal physiologic responses in stress echo? whether it is exercise, dobutamine or vasodilator.
almost the same normal response regardless to the method of choice
Coronary contributions via echo. which segment overlaps with coronary distribution
basal inferior and base to mid inferoseptal
- RCA
anterior, apical cap, apical septal
- LAD
purely supplied by the LCX alone- NONE!
mid inferoseptal, apical inferior - RCA or LAD
base to mid inferolateral - RCA or LCx
base to mid anterolateral, apical lateral - LAD or LCx
When to stop the stress echo?
five things to consider when to stop the test
What are the cut off hypertensive responses in exercise and DSE?
≥220mmHg in exercise
≥182mmHg/ ≥96mmHg in DSE
Coding for stress echo
see pic,
for WMSI computation,
WMSI = sum of each segment + number of segments
T/F? in peak DSE, Dobutamine can induced LVOTO in 10-25% of patients even in the absence of HCM.
TRUE!
