Stress Echocardiography: Its Role in the Diagnosis and Evaluation of Coronary Artery Disease (Developments in Cardiovascular Medicine (149))

W. F. ARMSTRONG While stress echocardiography is not the first technique to be applied to patients for the diagnosis of coronary artery disease, it represents an impor­ tant clinical tool, likely to become of increasing pertinence in today's era of cost containment and mandated cost-effectiveness of diagnosis. It may be the most rapidly expanding area of clinical echocardiography today. Stress echocardiography as we know it today represents the natural con­ clusion and merger of observations made over fifty years ago. In 1935 Tenn­ ant and Wiggers demonstrated that the immediate result of a coronary oc­ clusion, was an instantaneous abnormality of wall motion [1]. As viewed from the surface of the heart in an open chest dog preparation, cyanosis and obvious paradoxical bulging of the left ventricular wall was noted. At a similar time Masters and co-workers, using fairly rudimentary exercise de­ vices, described the response of the human cardiovascular system to sustained exercise (Figure 1) [2]. These two observations diverged for four decades while clinical investigation was pursued along the two parallel lines. Front Matter....Pages i-xvii Basic Considerations in the Pathophysiology and Detection of Ischemic Left Ventricular Dysfunction....Pages 1-10 How to Perform Stress Echocardiography — Practical Aspects....Pages 11-37 Exercise Echocardiography....Pages 39-59 Stress Echocardiography using Exercise-Simulating Techniques....Pages 61-80 Stress Echocardiography with Vasoactive Agents....Pages 81-94 Comparison of Exercise and Pharmacologic Stress Echocardiography and Electrocardiography....Pages 95-111 Comparison of Stress Echocardiography and Scintigraphic Techniques for the Diagnosis of Coronary Artery Disease....Pages 113-137 Use of Stress Echocardiography for Assessment of Interventions and Medical Treatments....Pages 139-145 Prognostic Value of Stress Echocardiography....Pages 147-162 Echocardiographic Determination of Myocardial Viability....Pages 163-178 Back Matter....Pages 179-182 This is a book which offers practical advice about the performance and interpretation of stress echocardiography. Many illustrations are offered to assist with learning the process of interpretation. The author has a broad background in non-invasive testing for coronary disease. Much effort has been directed towards discussion of the selection of appropriate stressors for different situations, and the comparison of stress echocardiography with other imaging techniques. Other books in the field have not attended to these comparisons in as much detail. Newer indications for the technique are discussed