The stress echo procedure is a safe and painless diagnostic test that uses high-frequency sound waves called ultrasound to capture moving images of the heart. It is often called stress cardiac ultrasound or an echo with a stress component. Soundwaves are directed at the heart from a small handheld transducer which is placed on your chest using gel to improve soundwave transmission. This is a test that evaluates blood flow to the heart to check for “blockages” in the heart arteries. It can assess chest pain, shortness of breath, fainting spells, heart rhythm problems, and known heart disease. It gives information about diagnosis, prognosis, and treatment effects. It gives ECG data as well as the echo/ultrasound data. It has much better accuracy compared to a treadmill stress ECG test. Its accuracy is the same as a “Thallium or Cardiolyte” nuclear stress test but at 1/3 the cost and without radiation exposure. It is provides more information about the structure/function of the heart and is much faster. The risks are the same as any stress test. A heart attack or other serious life threatening complication occurs in 1 in 5,000 tests. We have the necessary equipment/medication if this occurs.
The test takes 60 minutes in total. Patients will typically exercise for 6-10 minutes. The majority of my stress tests I use the supine bike is a vast majority of patients prefer this form of exercise to treadmill exercise. Utilizing the bike allows us to image throughout exercise so that we can diagnose an abnormality when it first occurs which makes the test safer. The ability to image throughout exercise as well as immediately after exercise improves picking up abnormalities as opposed to treadmill stress echo where we only get images immediately after exercise. The stress echo procedure has accuracy rates on the order of 85% for the detection of coronary artery blockages. Many measurements are taking during the stress echo procedure to assess how well your heart is functioning. We are able to see the heart valves, the heart chambers and measure their size. The function of the heart can be assessed and pressures within each chamber can be measured by echo. 4 dimensional echo equipment which we have had in my laboratory for many years allows us to see the heart the way it should instead of two-dimensional slices of the heart. After taking all of the resting images patients are exercised either on the supine bike or the treadmill.
Patients prefer the supine bike as they can control the speed of the bike and they do not have to worry about their balance if they were to be on the treadmill. Images are taken during exercise as well as immediately post exercise. The resting, peak exercise and immediately post exercise images are compared side-by-side to make an interpretation as to whether there is any reduction in blood flow causing regional cardiac muscle dysfunction. In this video, Dr. Moran will take you through each step of the stress echo procedure explaining as we go showing examples of the images and measurements that we do.
DISCLAIMER : Thank you for watching my YouTube video. The content of my video is not intended to be a substitute for professional medical advice, diagnosis or treatment. No doctor-patient relationship is formed by viewing this video. For further details, please click the following link below for my full disclaimer.
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Dr. Keith Moran MD, RCPSC, DABIM, RCS, NBE Biography:
I am a consultant in Internal Medicine with special medical interests in gastroenterology, cardiology, and echocardiography. I am a a full-time practising physician in these areas. I was an undergraduate at the University of Toronto, Trinity College where I received a number of scholarships including one for top student at Trinity College. I attended medical school at the University of Toronto graduating with a gold medal. My internship was completed at McMaster University in Hamilton followed by a residency in Internal Medicine at the University of Western Ontario in London. I then completed a fellowship in General Internal Medicine at the University of Western Ontario. I have active staff privileges and work as a consultant at my hospital managing the intensive care unit and providing consultative care in all hospital departments. I am a past clinical preceptor at the Northern Ontario School of Medicine. I am an active echocardiographer who has been certified and recertified by the National Board of Echocardiography. I am certified in cardiac sonography and have trained and completely educated a number of cardiac sonographers. I am the medical director of my cardiology laboratory which was established in 2001. My laboratory performs echocardiography and stress echocardiography amongst other tests. I maintain my certification in the American Board of Internal Medicine.
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https://ultrasoundclass.org/stress-echo-procedure-everything-you-need-to-know/
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