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Stress Echo and DSE
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Westy50
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Indications for Stress Echo include:
Unable to exercise
ECG Abnormalities
Inconclusive test
False positive
Territorial information required
Examples of ECG abnormalities meaning ETT could not be performed:
LBBB
RBBB
LVH/Strain
ST changes in rest
V Pacing
Excitable pathways
What does dobutamine act on?
Beta adrenoreceptor agonist (opposite to beta blocker)
What reverses the action of Dmine?
Beta blockers
What can Dmine do in high concentrations?
Hypotension and bradycardia
What does DSE aim to achieve:
Increase HR and BP
Induce ischaemia
85% target HR
How is ischaemia observed?
Wall motion abnormalities or ECG changes
What are some contra-indications of DSE?
Complete AV block
Unstable angina
Recent MI
Chest pain
LMS Stenosis
Uncontrollable AF
Hypokalaemia
Relative C-Indications for DSE?
Poor echo windows
Beta blocker ingestion
Side effects of DSE?
Chest pain
MI
Hypertension and Tachycardia
A&V Arrhythmias
Death
Hypotension & Bradycardia
Monitoring Stages for BP:
Every stage
New symptoms
Monitoring stages for heart rate and rhythm:
Continuously
Monitoring stages for symptoms:
Continuously
Monitoring stages for Wall motion abnormalities:
Every stage increment
Each dosage
New symptoms
DSE termination criteria:
Maximal heart rate achieved
: (220-age) x 0.85
BP drop of >20mmHg from baseline or previous reading
BP increase >240/120mmHg
Uncontrolable symptoms
Complex arrhythmias
New/worsening wall motion abnormalitites in two adjacent LV segments or associated with V dilation
Global reduction in V systolic function
Other drugs used:
Adenosine
Dipyridamole
Regadenoson
Author:
Westy50
ID:
154424
Card Set:
Stress Echo and DSE
Updated:
2012-05-17 17:39:49
Tags:
Stress Echo
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