Q. What is Interpretation of Stress Echocardiography?

The standard approach to interpretation is qualitative. The attendant need for training and problems posed for reproducibility of the test are the greatest shortcomings of this technique.

Visual assessment is based on analysis of thickening (rather than motion, which may be influenced by translation or tethering) before, during, and after stress. A systematic approach to review is essential. On the resting images, global function is assessed by calculation of wall motion score index or ejection fraction, and regional function is evaluated using regional wall motion scoring. Rest and stress images are then compared for the development of global dysfunction (left ventricular enlargement and shape changes) and regional dysfunction. A normal response involves the augmentation of function in all segments. The presence of a new or worsening wall motion abnormality identifies ischaemia, but rather than identifying the test as simply positive, the site, extent, and severity of abnormal function should be identified, as well as the ischaemic threshold if a bicycle or dobutamine stress study is being examined.