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PHARMACOLOGICAL STRESS ECHOCARDIOGRAPHY

PHARMACOLOGICAL STRESS ECHOCARDIOGRAPHY. Dr. Benny J Panakkal Senior Resident Dept. of Cardiology Medical College, Kozhikode. Understanding Basic Concepts. Ischemia Cascade The answer to the Question “Why Echo”. Why Echo in comparison to SPECT, PET etc. Stressors in Stress Testing.

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PHARMACOLOGICAL STRESS ECHOCARDIOGRAPHY

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  1. PHARMACOLOGICAL STRESS ECHOCARDIOGRAPHY Dr. Benny J Panakkal Senior Resident Dept. of Cardiology Medical College, Kozhikode

  2. Understanding Basic Concepts

  3. Ischemia Cascade The answer to the Question “Why Echo”

  4. Why Echo in comparison to SPECT, PET etc.

  5. Stressors in Stress Testing

  6. Exercise as a Stressor • Prototype of Demand driven ischemic stress

  7. Situations where Pharmacological Stress is preferred to Exercise Stress

  8. Adverse Effects and Complications

  9. Protocols

  10. Exercise Stress Test Protocol

  11. Dipyridamol Stress Echo Protocol

  12. Ergonovine Stress Protocol for Coronary Vasospasm

  13. Imaging Equipment and Acquisition

  14. Quad screen Format Normal response to Exercise, Dobutamine or Pacing Stress Echo

  15. Contrast Echo and 3D Imaging

  16. How Contrast Echo improves Endocardial border defintion

  17. Excessive Gain setting spoiling the Endocardial border definition

  18. Comparing Similar looking but totally different views

  19. TDI in Stress Echo

  20. Applying Strain Rate Imaging in Stress Echo Resting

  21. Applying Strain Rate Imaging in Stress Echo Low dose Dobutamine

  22. Applying Strain Rate Imaging in Stress Echo High dose Dobutamine

  23. The Do(s) and Don’t(s)

  24. Indications of Stress Echo

  25. Special clinical conditions and target endpoints in Stress Echo

  26. Diagnostic and Prognostic value of CFR during Vasodilator testing

  27. Interpretation

  28. Wall motion scoring and attribution to coronary vascular territories

  29. Interpretation of Pharmacological and Exercise Stress Echo

  30. Differential responses to Exercise and Dobutamine Stress Echo

  31. Contents of Stress Echo Report

  32. Statistics, Studies The Comparison

  33. Single Centre Analysis ( >50,000 studies ) – Mayo Clinic SVT and AF are more common than VT/VF

  34. Diagnostic Accuracy - Overall Sensitivities in CAD subtypes Pellikka PA: Stress echocardiography for the diagnosis of coronary artery disease: Progress towards quantification. CurrOpinCardiol 20:395, 2005. Armstrong WF, Zoghbi WA: Stress echocardiography: Current methodology and clinical applications. J Am CollCardiol 45:1739, 2005

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