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Stress Echo, as a test for the control of coronary artery disease, is a fast and effective test, which utilizes ultrasound technology to control cardiac function under load-fatigue conditions.

It is a test that provides important information on both the overall and segmental function of the myocardium, checking both its movement and thickening.

As a functional diagnostic test, it is now a first-choice test (class I) for the diagnosis of coronary artery disease, in contrast to the simple stress test (class IIb).

Furthermore, if the findings of the coronary angiography (class I) show stenosis <90% (non-diagnostic), then the next test is again the Stress Echo.

The above are guidelines from the European Society of Cardiology for the investigation of Coronary Artery Disease.

In general, the Stress Echo is performed in two main ways:

A. Stress echo with dobutamine (Dynamic Echocardiographic Study)

The examination is performed with a specific protocol of loading with dobutamine, administration of an echo contrast agent (a special contrast agent) and finally administering a beta-blocker intravenously. In some cases, atropine is also administered intravenously.

It is a test of choice for women and men that offers:

• Early and valid diagnosis of coronary artery disease in one or more vessels, in patients with suspected or known coronary artery disease.
• Complete viability test or monitoring of the myocardium in patients with known coronary artery disease and a previous heart attack.
• Detailed prognosis of patients with known or unknown coronary artery disease, such as patients with diabetes mellitus, renal dysfunction, hypertension and elevated cholesterol.
• Complete preoperative screening of patients who are about to undergo cardiac or non-cardiac surgery.

B. Stress echo with ergometric bicycle

This examination is performed to investigate valvular diseases and hypertrophic cardiomyopathy, to check myocardial viability, but also to predict the prognosis of patients.

In addition, it is increasingly used to investigate unexplained dyspnea (shortness of breath) with easy fatigue or at rest.

However, it can also be used to investigate coronary artery disease.

Advantages

Stress Echo is distinguished by many advantages, such as:

• The administration of radioactive medicine to the patient is avoided, as would be the case with scintigraphy, making Stress Echo completely safe in terms of the emission of radioactive material.
• Thus, the examinee does not need to avoid contact with children and pregnant women, while he does not need to use another toilet for at least 3 days, as in the case of scintigraphy.
• The contrast agent, which may be used, is not metabolized in the kidneys, therefore the patient does not need to prepare by taking fluids before or after the examination, making it the examination of choice even in patients with mild or more severe renal failure.
• As a stress-exhaustion test, it has the negligible risk that a simple test would have fatigue.
• After the end of the examination, the patient can continue his daily activities normally.

The examination should be performed by a specialized cardiologist with certification in this particular examination and of course with the assistance of an experienced nurse during the examination.

In addition, the latest generation ultrasound machines should be used, while the laboratory where the examination is performed must be certified.

Thanks to the state-of-the-art equipment and infrastructure of the standard Cardiological Center of the Heart and Vascular System, “Athens Heart Center” and in collaboration with pioneers and top-level cardiologists, the investigation and treatment of any cardiac problem can be done safely, effectively and with the best medical outcome for the patient.