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Dobutamine Stress Echo: Difference between revisions
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If there is an increase in stroke volume, an increase in AVA ≥ 0.3cm ² and a small change in gradient produced after administration of Dobutamine there is an overestimation of the severity of aortic stenosis (= pseudo stenosis). | If there is an increase in stroke volume, an increase in AVA ≥ 0.3cm ² and a small change in gradient produced after administration of Dobutamine there is an overestimation of the severity of aortic stenosis (= pseudo stenosis). | ||
A DSE may also demonstrate a severe aortic stenosis with low transvalvular pressure gradient or contractile reserve. Contractile reserve has a predictive value for mortality in surgery of aortic valve replacement. Recent studies have shown that perioperative mortality 5-8 % versus 32 % without contractile reserve in contractile reserve. | A DSE may also demonstrate a severe aortic stenosis with low transvalvular pressure gradient or contractile reserve. Contractile reserve has a predictive value for mortality in surgery of aortic valve replacement. Recent studies have shown that perioperative mortality 5-8 % versus 32 % without contractile reserve in contractile reserve.<cite>2</cite> | ||
==Indication DSE== | |||
{| class="wikitable" cellpadding="0" cellspacing="0" border="0" width="400px" | |||
Indications for DSE | |- | ||
!Indications for DSE | |||
Inability to perform bicycle test | |- | ||
Known for determining coronary ischemia before and after revascularization | |Suspected coronary artery disease | ||
Known coronary artery disease to determine areas of ischemia | |- | ||
Preoperatively, to assess risk, with large myocardial infarction. | |Inability to perform bicycle test | ||
Detection of viability | |- | ||
|Known for determining coronary ischemia before and after revascularization | |||
|- | |||
|Known coronary artery disease to determine areas of ischemia | |||
|- | |||
|Preoperatively, to assess risk, with large myocardial infarction. | |||
|- | |||
|Detection of viability | |||
|} | |||
==Contra-indication DSE== | |||
Acute myocardial infarction (≤ 4-10 days) | {| class="wikitable" cellpadding="0" cellspacing="0" border="0" width="400px" | ||
Unstable angina | |- | ||
Known relevant main stem stenosis | !Contra-indications for DSE | ||
Congestive heart failure | |- | ||
|Acute myocardial infarction (≤ 4-10 days) | |||
|- | |||
Hypertrophic obstructive cardiomyopathy | |Unstable angina | ||
Acute pericarditis, myocarditis, endocarditis | |- | ||
|Known relevant main stem stenosis | |||
|- | |||
|- | |||
|Congestive heart failure | |||
|- | |||
|Serious tachyarrhytmiën | |||
|- | |||
|Serious klepstenosen | |||
|- | |||
|Hypertrophic obstructive cardiomyopathy | |||
|- | |||
|Acute pericarditis, myocarditis, endocarditis | |||
|- | |||
|Aortic dissection | |||
|} | |||
==References== | ==References== | ||