Stress Echocardiography and Echo in Cardiopulmonary Testing

Stress echocardiography is an established tool to assess for both myocardial ischemia and viability. However, the utility of exercise echocardiography extends beyond the evaluation of coronary artery disease. Assessing the cardiovascular response to exercise can also be used to unmask the presence of, and to assess the severity of, valvular heart disease, heart failure (HF), hypertrophic cardiomyopathy (HCM), and pulmonary hypertension (PH). Resting echocardiography may not fully capture the dynamic nature of these diseases, which are influenced by loading conditions and changes in cardiac output. In this chapter, we review the use of exercise and pharmacologic stress echocardiography for evaluation of myocardial ischemia and viability. We also discuss the most relevant exercise echocardiographic assessments for individual valvular lesions, HCM, PH, and HF with preserved ejection fraction, along with the existing data supporting these assessments.