- Stress (treadmill) echocardiography has been found to have better sensitivity and specificity than treadmill stress testing alone.
- Stress echocardiography is used to evaluate changes in wall motion when the patient is at rest and under stress.
- Stress echocardiography can be coupled with pharmacologic stress testing. Myocardial perfusion imaging with dobutamine, adenosine, and dipyridamole is an alternative for patients who cannot exercise due to degenerative joint disease, physical deconditioning, neurologic disorders, COPD, or peripheral vascular disease.
Nursing and Patient Care Considerations
- Explain procedure to patient and provide written information, if possible.
- Withhold caffeine-containing products for 24 hours before adenosine and dipyridamole stress testing.
- Discuss with physician which medications should be withheld before test.
- Maintain NPO status before testing for 2 hours or according to facility policy.
- Establish a patent I.V. access.
- The results of the study will be discussed with patient by the physician or primary care provider.
DRUG ALERT
Theophylline-containing products should be discontinued 48 to 72 hours before an adenosine or dipyridamole stress test. Patients receiving oral dipyridamole or aggrenox should not be given I.V. adenosine because of potential for precipitating severe heart block. If possible, beta-adrenergic blockers should be withheld for 48 to 72 hours before a dobutamine stress test.
