Indications for DSE/ESE
1. Evaluation of known or suspected CAD (a. Use tissue harmonic imaging; b. Intravenous contrast agent used if ≥ 2 myocardial segments are not well visualized).
2. Risk stratification prior to noncardiac surgery.
3. Risk stratification post MI, PCI, CABG.
4. Assessment of myocardial viability.
5. Evaluation of valvular hemodynamics.*
6. Evaluation of pulmonary hypertension.
7. Evaluation of unexplained dyspnea.
Contraindications
Absolute
1. MI<48 hours.
2. Unstable angina (chest pain <12 hours).
3. Absolute intolerance to dobutamine/beta-blockers/nitro.
4. Symptomatic arrhythmias.
5. Uncooperative or unwilling patient.
6. Active sepsis/endocarditis.
7. Severe metabolic/electrolyte abnormalities.
8. Highly mobile intracardiac mass.
9. Uncontrolled seizure disorder.
10. Known pregnancy.
