Pharmacological stress echocardiography in the evaluation of coronary artery disease

This article deals with the application of pharmacological stress echocardiography, a relatively new and evolving technique, to the diagnosis and assessment of patients with coronary artery disease. The value of echocardiography in ischaemic heart disease is initially outlined, followed by a brief review of the exercise two-dimensional echocardiography and exercise echo-Doppler literature. Dipyridamole, adenosine and dobutamine stress echocardiography are then examined, and the rationale and potential advantages of this approach explained. The findings of our own work using dipyridamole and dobutamine stress, combined with both two-dimensional echocardiography and Doppler, are then described. A review of the various methods of echocardiographic image analysis is then presented and the article concludes by suggesting directions for future work.