313 Prognostic implications of semi-supine exercise stress echocardiography for the evaluation of chest pain in the emergency room

1999 ◽  
Vol 1 ◽  
pp. S26-S26
Author(s):  
P LANCELLOTTI ◽  
E HOFFER ◽  
H APPELTANS ◽  
A GHUYSEN ◽  
V DORIO ◽  
...  
Keyword(s):  
Chest Pain ◽  
Emergency Room ◽  
Stress Echocardiography ◽  
Exercise Stress ◽  
Exercise Stress Echocardiography ◽  
Prognostic Implications

scholarly journals Upright exercise stress echocardiography may unmask dynamic left ventricular obstruction also beyond hypertrophic cardiomyopathy

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
C Cotrim ◽  
H Cafe ◽  
I Goncalves ◽  
J Guardado ◽  
N Cotrim ◽  
...  
Keyword(s):  
Chest Pain ◽  
Hypertrophic Cardiomyopathy ◽  
Sudden Death ◽  
Stress Echocardiography ◽  
Continuous Wave ◽  
Left Ventricular ◽  
Exercise Stress ◽  
Exercise Stress Echocardiography ◽  
Left Ventricular Outflow ◽  
Orthostatic Position

Abstract Background Dynamic left ventricular outflow obstruction (LVOTO) during exercise stress echocardiography (ESE) is recommended in hypertrophic cardiomyopathy (HCM) to identify the obstructive phenotype. Aim To assess left ventricular outflow gradient (LVOTG) during ESE in different conditions. Methods In a single-group, prospective, observational study, we performed peak and/or post-treadmill ESE with systematic assessment of LVOTG in the orthostatic position by continuous-wave Doppler in 1333 subjects (837 males, mean age 38,2±20 ranging from 6 to 87 years) recruited over a period of twenty years, from 2001 to 2021. Peak LVOTG ≥30 mm Hg was considered abnormal for LVOTO during ESE. We enrolled 7 different populations: asymptomatic healthy controls (n=35); HCM (n=81); genotype-positive, phenotype negative asymptomatic HCM (n=6); patients with chest pain symptoms, suspected myocardial ischemia and either normal coronary arteries (INOCA, n=131,or with very low pre-test probability of coronary artery disease (probable INOCA, n=416) and; fatigue and suspected heart failure with preserved ejection fraction (HFpEF, n=206); amateur athletes with ischemia-like ECG changes during exercise-test or symptoms such as near syncope or chest pain or dizziness (n=457); aborted sudden death and with negative screening (n=1). Results Technical success rate of LVOTG assessment was 1333/1333 at rest and at peak stress (feasibility 100%). Imaging and analysis time were <1 minute. LVOTG at rest was present in 25 pts (2.8%) of the overall population: 23 HCM, 1 INOCA, and 1 HFpEF. Overall prevalence during ESE was 432/1333 (32%). During ESE, LVOTO (see Figure 1 and 2) was 0% (0/35) in normals, 58% (47/81) in HCM (23 with obstruction at rest), 33% (2/6) in genotype-positive, phenotype negative HCM, 37% (33/131) in INOCA, 40% (135/416) in athletes and 1/1 in the patient with aborted sudden death on strenuous exercise. Conclusion LVOTO in orthostatic position is detectable during treadmill ESE in several cardiovascular conditions associated with symptoms such as dyspnea, chest pain or near syncope, and even in asymptomatic patients with genotype-positive, phenotype-negative HCM. The identification of the obstructive phenotype is easy to capture during ESE without any significant additional imaging and analysis burden and can be important also outside HCM. FUNDunding Acknowledgement Type of funding sources: None. Figure 1 Figure 2

scholarly journals Emergency Department Evaluation of Chest Pain Using Exercise Stress Echocardiography

2001 ◽  
Vol 8 (2) ◽  
pp. 196-199 ◽  
Author(s):  
Michael S. Buchsbaum ◽  
Erik S. Marshall ◽  
Brian J. Levine ◽  
Martin A. Bennett ◽  
Angela DiSabatino ◽  
...  
Keyword(s):  
Emergency Department ◽  
Chest Pain ◽  
Stress Echocardiography ◽  
Exercise Stress ◽  
Exercise Stress Echocardiography ◽  
Department Evaluation

Inconclusive Exercise Stress Echocardiography in Patients With Chest Pain: Prevalence and Clinical Determinants

2018 ◽  
Vol 71 (5) ◽  
pp. 406-408
Author(s):  
Pedro J. Flores-Blanco ◽  
Francisco Cambronero ◽  
Miguel García-Navarro ◽  
Gonzalo de la Morena ◽  
Mariano Valdés ◽  
...  
Keyword(s):  
Chest Pain ◽  
Stress Echocardiography ◽  
Exercise Stress ◽  
Exercise Stress Echocardiography ◽  
Pain Prevalence

scholarly journals P794 Treadmill exercise stress echocardiography in children; our experience.

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
C Cotrim ◽  
I Joao ◽  
J Guardado ◽  
P Cordeiro ◽  
M ANA Sampaio ◽  
...  
Keyword(s):  
Chest Pain ◽  
Stress Echocardiography ◽  
Continuous Wave ◽  
Left Ventricular ◽  
Exercise Stress ◽  
Exercise Stress Echocardiography ◽  
Group I ◽  
Ecg Alterations ◽  
Group Ii ◽  
Exercise Induced

Abstract Background Exercise stress echocardiography (ESE) is routinely used in adults but its role in children (C) is less established Purpose To assess the feasibility and clinical value of ESE in outpatient children Methods We enrolled 309 consecutive C (mean age = 14,1 ± 2,6 years, range 6-17 yrs) who underwent treadmill ESE between 2002 and 2019: One group (Group I) of 258 C including: 237 with exercise related symptoms (chest pain and/or dyspnea and/ or lypotimia-syncope), 15 with resting ECG alterations, 6 with positive ECG stress test and other group of C (Group II) including: 10 asymptomatic for screening requested by parents, 11 with symptoms unrelated to exercise, 12 with antecedents of sudden death in the family, and 17 with known pathology - 10 with hypertrophic cardiomyopathy, 2 with aortic coarctation, 1 each with Cortriatriatum sinister, pulmonary stenosis, subaortic stenosis, bicuspid aortic valve, left ventricular hypertrophy related to arterial hypertension, aortic switch operation. Regional wall motion abnormalities (RWMA) by 2-D and continuous wave Doppler (transvalvular or transaortic or intraventricular (IVG) gradients were assessed in all. Results The success rate was 309/309 (100%). Only one complication (allowing asthma diagnosis by serendipity) occurred: a severe asthmatic crisis in one girl studied because of chest pain with exercise (with ESE negativity), Stress-induced RWMA occurred in 2 pts (one with HCM, the other with normal coronary arteries). A significant orthostatic exercise induced IVG (> 30 mmHg) was present in 101 of the 258 C (39%) studied due to symptoms, ECG alterations or positive stress ECG. In group II the C with induced IVG attained greater heart rate (HR) 184 ± 12 vs 174 ± 16 (p < 0,001); greater blood pressure (BP) 150 ± 19 mmHg vs 136 ± 23 mmHg (p < 0,001). The OR to the reproduced symptoms that motivated the exam during the SE comparing the 101 C with IVG with the 158 without IVG was 8,22 (4,83-13,99) p < 0,001 (95% CI). Conclusions Treadmill ESE is feasible and safe in young people. RWMA are of limited usefulness in our outpatient C group. Doppler often documents significant exercise induced IVG, occult at rest that associate with symptoms. Abstract P794 Figure. ESE Induced IVG in a C with chest pain

scholarly journals IMMEDIATE EXERCISE STRESS ECHOCARDIOGRAPHY FOR SAFE DISCHARGE IN LOW RISK CHEST PAIN PATIENTS IN THE EMERGENCY DEPARTMENT

2013 ◽  
Vol 61 (10) ◽  
pp. E1103
Author(s):  
Yuanyuan Zhang ◽  
Brian Levine ◽  
Mary-Stewart Grote ◽  
Danielle Minett ◽  
Avkash Patel ◽  
...  
Keyword(s):  
Emergency Department ◽  
Chest Pain ◽  
Stress Echocardiography ◽  
Low Risk ◽  
Exercise Stress ◽  
Exercise Stress Echocardiography ◽  
Pain Patients
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