Dobutamine stress echocardiography.

Two-dimensional echocardiography is a versatile, accurate, and readily available method for the assessment of cardiac anatomy and function, and extensive experience has been gained in the analysis of left ventricular wall motion. Using modern imaging techniques, regional as well as global wall motion analysis can be performed. Echocardiography can be used in conjunction with a protocol for either exercise or pharmacologic cardiovascular stress in order to identify the distribution and severity of coronary artery disease, with the induction of a regional wall motion abnormality being a sign of myocardial ischemia. The use of dobutamine infusion to accomplish stress echocardiography is a safe, accurate, and practical method for the diagnosis of coronary artery disease in patients unable to exercise. In addition to the evaluation of inducible ischemia, preliminary work is being performed with dobutamine stress echocardiography for the assessment of risk and patient prognosis following acute myocardial infarction and as an indication of tissue viability for myocardium that remains dysfunctional at rest following thrombolytic therapy.