Chapter 19 Related Diagnostic Modalities Steven Gill, John C. Sciarra and Christopher J. Gallagher Stress TEE is the same deal as a transthoracic stress echo. You get a baseline reading, stress the heart with some dobutamine, kick up the heart rate to marathon levels and do another exam. Besides seeing a heart running like a race horse, you will also see the hyperdynamic heart and any new wall motion abnormalities compared to the baseline resting heart. When you crank up the dobutamine, new wall motion abnormalities might pop-up revealing at risk myocardium, right? Well, not always. Sometimes, low-dose dobutamine improves ventricular function, but othertimes, you might see a biphasic response which is improving response until reserve is exhausted. At which point you start to fall off the old Starling curve and ventricular function declines to the point of what we call scientifically—“Dead-as-a-doornail” myocardium. That is no response to redbull levels of whipping the heart. The Gologorsky method of creating a spacer for epicardial scanning: just fill the tip with gel and place in a sheath. Another common method is to fill a sterile glove with gel or water and use that as a stand-off or spacer.
Stress Echocardiography
Epicardial Scanning
Thoracic Key
Fastest Thoracic Insight Engine
