Background: In stress echocardiography, ischaemia is detected as wall motion abnormalities. The test can be done both with exercise (which is the more sensitive) and pharmacological stress (which is more specific).
Material and methods: The paper gives an overview of the method, of diagnostic and prognostic value as well as indications and contraindications, based on present literature.
Results and interpretation: The sensitivity is 80-90%, specificity 75-100%, dependent on the extent and degree of disease. A negative test predicts a low cardiac event rate of about 1% per year and a low preoperative cardiac risk. The diagnostic accuracy is dependent on optimal equipment quality and on the experience of the examiner. Without specific training, sensitivity is about the same as with exercise ECG. The complication rate is low, dependent on the type of stress. Stress echocardiography is useful in patients unable to exercise, in preoperative risk assessment and in suspected false-negative exercise ECG. In addition it is a supplement to coronary angiography for evaluation of the significance of intermediate stenoses, to identify culprit lesion and for viability detection. Finally, it is useful in aortic stenosis with reduced left ventricular function for evaluation of stenosis and contractile reserve.