Stress Echo and DSE

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Author:
Westy50
ID:
154424
Filename:
Stress Echo and DSE
Updated:
2012-05-17 13:39:49
Tags:
Stress Echo
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  1. Indications for Stress Echo include:
    • Unable to exercise
    • ECG Abnormalities
    • Inconclusive test
    • False positive
    • Territorial information required
  2. Examples of ECG abnormalities meaning ETT could not be performed:
    • LBBB
    • RBBB
    • LVH/Strain
    • ST changes in rest
    • V Pacing
    • Excitable pathways
  3. What does dobutamine act on?
    Beta adrenoreceptor agonist (opposite to beta blocker)
  4. What reverses the action of Dmine?
    Beta blockers
  5. What can Dmine do in high concentrations?
    Hypotension and bradycardia
  6. What does DSE aim to achieve:
    • Increase HR and BP
    • Induce ischaemia
    • 85% target HR
  7. How is ischaemia observed?
    Wall motion abnormalities or ECG changes
  8. What are some contra-indications of DSE?
    • Complete AV block
    • Unstable angina
    • Recent MI
    • Chest pain
    • LMS Stenosis
    • Uncontrollable AF
    • Hypokalaemia
  9. Relative C-Indications for DSE?
    • Poor echo windows
    • Beta blocker ingestion
  10. Side effects of DSE?
    • Chest pain
    • MI
    • Hypertension and Tachycardia
    • A&V Arrhythmias
    • Death
    • Hypotension & Bradycardia
  11. Monitoring Stages for BP:
    • Every stage
    • New symptoms
  12. Monitoring stages for heart rate and rhythm:
    Continuously
  13. Monitoring stages for symptoms:
    Continuously
  14. Monitoring stages for Wall motion abnormalities:
    • Every stage increment
    • Each dosage
    • New symptoms
  15. 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
  16. Other drugs used:
    • Adenosine
    • Dipyridamole
    • Regadenoson

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