Noninvasive evaluation of coronary artery disease and myocardial viability through stress echocardiography and myocardial perfusion imaging.
Today, primary care providers are managing clinical problems that were frequently addressed by a "specialist". Consequently, they must keep current with myriad state-of-the-art diagnostic modalities. In the case of coronary artery disease, knowledge about the reversibility of left ventricular dysfunction conceptualized as "hibernating" and "stunned" myocardium has resulted in an increased utilization of noninvasive cardiac imaging techniques to facilitate clinical decision making. These procedures provide diagnostic and prognostic information about coronary artery disease and left ventricular function beyond that provided by the conventional exercise stress test. The most commonly employed of these are the stress echocardiogram and stress myocardial nuclear perfusion procedures. Both modalities can be performed in conjunction with physical or pharmacologically induced stress, and may be performed on an outpatient basis. Knowledge of how these procedures are performed and the clinical data they provide will facilitate primary care providers as they care for this growing population.
Beattie
S
S
Harry S. Truman VA Hospital, Columbia, MO, USA.
Stapleton
A
A
D002316:Cardiotonic Agents; D003327:Coronary Disease / Q000175:diagnosis*; D004280:Dobutamine; D004452:Echocardiography / Q000379:methods; D005080:Exercise Test / Q000379:methods; D006321:Heart / Q000000981:diagnostic imaging* / Q000502:physiology*; D006801:Humans; D011877:Radionuclide Imaging; D014022:Tissue Survival
D002316:Cardiotonic Agents; D004280:Dobutamine