Echocardiographic Evaluation of Coronary Artery Disease

Echocardiographic evaluation of patients with coronary artery disease (CAD) is a low cost, portable, and non-invasive imaging tool that is available in almost all hospitals and in many office settings. Detection of a discreet impairment in regional left ventricular mechanical function by echocardiography provides real time cardiac imaging useful in the evaluation and diagnosis of acute and chronic CAD. Echocardiography helps to establish the diagnosis, location, and extent of ischemia and it identifies mechanical complications of infarction and provides prognostic information for risk stratification. Stress echocardiography, by induction of regional wall motion abnormalities with treadmill or bicycle exercise or following dobutamine pharmacologic stress, is routinely used to demonstrate the presence of CAD, to risk stratify patients, and to assess myocardial viability prior to revascularization. Newer echocardiographic parameters, such as strain rate and perfusion, have improved the accuracy in CAD detection and are complementary adjuncts in stress echocardiography.