Complementary value of two-dimensional exercise echocardiography to routine treadmill exercise testing.

Two-dimensional echocardiograms were done during rest and after exercise in 95 patients who subsequently had coronary arteriography. Prior myocardial infarction was present in 36 patients, 35 of whom had wall motion abnormalities. There was no evidence of prior infarction in 59 patients, 44 of whom had coronary disease. In these 44 patients, the exercise electrocardiogram showed ischemia in 19, was normal in 13, and was nondiagnostic in 12. Exercise echocardiograms were abnormal in 35 of these 44 patients. In 15 patients without coronary disease, the treadmill response was nondiagnostic in 6, ischemic in 1, and normal in 8. Exercise echocardiograms were normal in 13 of these 15 patients. We conclude that exercise echocardiography is a valuable addition to routine treadmill testing. It may be of special value in patients with an abnormal resting electrocardiogram or a nondiagnostic response to treadmill testing or when a false-negative treadmill test is suspected.