Stress echocardiography in special subsets of clinically defined patients: Elderly, women, outpatients, chest pain unit, and noncardiac surgery

Abstract

Clinically defined conditions pose special challenges to stress echo. Pharmacological stress echo is the favorite method in the elderly for the frequent limitation to exercise. Stress echo is the first choice in women, especially vulnerable to the cancer effects of radiation exposure since the breast is a highly radiosensitive organ. In the emergency department, the specificity of stress echo based on regional wall motion abnormality is extremely high and superior to other techniques but the sensitivity for predicting events is suboptimal and can be improved considering coronary flow velocity reserve and heart rate reserve. A Pharmacologic stress echo is recommended before high-risk surgery in patients with =3 clinical risk factors and poor functional capacity (<4 METs). Pharmacologic stress echo may be considered before high or intermediate-risk surgery in patients with suspected cardiac symptoms and poor functional capacity. © The Author(s), 2023. All rights reserved.