When evaluated by echocardiography, regional WMA must be detected visually in at least two
echocardiographic views, as artefactual WMA could be the result of
the angle of insonation.
This is not necessary when wall motion is evaluated by other imaging modalities (CT, CMR, nuclear).
Of note, WMA during stress testing may be caused by a variety of other conditions not related to CAD.
The criteria for an abnormal response involve not only abnormal contraction but also failure of a segment to manifest an
appropriate increase in contractility in response to stress.
Patients who are able to exercise should undergo exercise stress testing since it represents a true physiologic response. Exercise stress provides additional prognostic information (compared to pharmacological stress) based on ECG results, exercise capacity, time to symptoms, and blood pressure response.