Atualize seu conhecimento: Exercise stress is preferable to pharmacologic stress for patients who are capable of performing an exercise test



A major advantage of supine bicycle ergometry is that it allows continuous monitoring of wall motion during exercise. Imaging throughout the study may permit detection of the onset of wall motion abnormalities and improve sensitivity of detection of coronary artery disease [9,10]. Moreover, acquisition of Doppler imaging during each stage of exercise is also feasible during supine bicycle exercise.



INDICATIONS — There are several specific indications for stress echocardiography [1,3,4]:

Evaluation of patients with known or suspected coronary artery disease.

Assessment of myocardial viability. (See “Dobutamine stress echocardiography in the evaluation of hibernating myocardium” and “Evaluation of hibernating myocardium”.)

Evaluation of dyspnea of possible cardiac origin. (See “Approach to the patient with dyspnea”.)

Evaluation for pulmonary hypertension, as pulmonary artery systolic pressure can be estimated at rest and with exercise. (See “Clinical features and diagnosis of pulmonary hypertension in adults”.)

Evaluation of mitral valve disease, including mitral stenosis and mitral regurgitation. (See “Clinical manifestations and diagnosis of rheumatic mitral stenosis”, section on ‘Stress testing’ and “Clinical manifestations and diagnosis of chronic mitral regurgitation”, section on ‘Stress testing’.)

Evaluation of aortic stenosis. Stress echocardiography may be reasonable and helpful in patients with low gradient aortic stenosis or asymptomatic aortic stenosis. (See “Clinical manifestations and diagnosis of low gradient severe aortic stenosis”.)

Evaluation of left ventricular outflow tract gradients, mitral regurgitation, and pulmonary hypertension in patients with hypertrophic cardiomyopathy. (See “Hypertrophic cardiomyopathy: Clinical manifestations, diagnosis, and evaluation”, section on ‘Exercise testing’.)


A bicicleta permite as avaliações acima com o máximo de produtividade.



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