Cardiovascular imaging
• General principles of stress tests
• Stress ECG
• Transthoracic echocardiography (TTE)
• Dobutamine stress ECHO
• Transesophageal echocardiography (TOE)
• Perfusion scintigraphy (SPECT)
• CT angiography (CTA) / coronarography (CTC)
• Cardicac MRI (CMRI)
• Invasive coronary angiography (ICA) / peripheral angiography
• Invasive hemodynamic measurement
, General principles of stress tests
• Ischemia testing
• Maximal workload testing (VO2max)
• Contractile reserve testing
• Viability testing
• Before the test:
– Assess the pretest probability
– Know sensitivity and specificity
– Are there therapeutic consequences?
, Ischemia testing
• What type of test and how to induce ischemia?
• Would stress ECG be diagnostic (LBBB, RBBB, WPW,
stimuation, ST-segment changes: cardiomyopathy, LV
hypertrophy, aortic stenosis, digoxin)?
• Is exercise on ergometer or treadmill possible?
• Shall I use vasodilating agent (dipyridamol,
regadenoson, adenosine, nitroglycerine)?
• Shall I use inotropic agent (dobutamine)?
• General principles of stress tests
• Stress ECG
• Transthoracic echocardiography (TTE)
• Dobutamine stress ECHO
• Transesophageal echocardiography (TOE)
• Perfusion scintigraphy (SPECT)
• CT angiography (CTA) / coronarography (CTC)
• Cardicac MRI (CMRI)
• Invasive coronary angiography (ICA) / peripheral angiography
• Invasive hemodynamic measurement
, General principles of stress tests
• Ischemia testing
• Maximal workload testing (VO2max)
• Contractile reserve testing
• Viability testing
• Before the test:
– Assess the pretest probability
– Know sensitivity and specificity
– Are there therapeutic consequences?
, Ischemia testing
• What type of test and how to induce ischemia?
• Would stress ECG be diagnostic (LBBB, RBBB, WPW,
stimuation, ST-segment changes: cardiomyopathy, LV
hypertrophy, aortic stenosis, digoxin)?
• Is exercise on ergometer or treadmill possible?
• Shall I use vasodilating agent (dipyridamol,
regadenoson, adenosine, nitroglycerine)?
• Shall I use inotropic agent (dobutamine)?
