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Heart Disease (Expert Forum)
Stress echo vs dobutamine stress echo
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Stress echo vs dobutamine stress echo
by PJF, Jan 25, 2007 12:00AM
I am 64, 165# and generally in good health. I am on statins (Advicor 1000/20 plus 1000 mg of time-released niacin - Niaspan)as well as low-dose aspirin. My last lipid panel (Aug 2006) showed LDL 56 and HDL 83; VAP results were HDL-2 30, HDL-3 53, VLDL-3 7, Sum Total LDL-C 56 and Real-LDL size pattern was in the A/B range, closer to pattern A. I recently had to change doctors and because I have had a couple of heart scans (the first in 2001 and the last in 2005)that show calcification in the LAD (Agatston score 105.06) and RCA (Agatston score 179.21), my new doctor recommended a dobutamine stress echo test. I've never had a stress test and what I read about the dobutamine stress test is that it is used when the patient cannot do the exercise stress test. I am fit and exercise strenuously and regularly (4-5 times a week) without adverse affects.
Is there some advantage to the dobutamine test that I am not seeing in the literature available?
Am I better off to take the exercise stress echo test?
I have also read that the 3D echo is much preferable to the 2D -please comment.
Is there some advantage to the dobutamine test that I am not seeing in the literature available?
Am I better off to take the exercise stress echo test?
I have also read that the 3D echo is much preferable to the 2D -please comment.
Doctor's Answer
by CCF-M.D.-MJM, Jan 25, 2007 12:00AM
Hello,
Exercise stress tests are preferred to domutamine echo's because it gives additional information about functional capacity and a real look at your EKG on real-life condition. If you can exercise, exercise echo is the right test.
If you aren't having symptoms, the other question is do you even need a stress test. There is only a proven benefit to cardiac cath with stenting or bypass in the setting of symptomatic chest pain or equivalent. Unless there is another pressing issue that you didn't mention, I am not sure that you need a stress test at this time.
3D echo is more of research tool now. 2D echo is just fine for the procedure.
I hope this answers your questions. good luck and thanks for posting.
Exercise stress tests are preferred to domutamine echo's because it gives additional information about functional capacity and a real look at your EKG on real-life condition. If you can exercise, exercise echo is the right test.
If you aren't having symptoms, the other question is do you even need a stress test. There is only a proven benefit to cardiac cath with stenting or bypass in the setting of symptomatic chest pain or equivalent. Unless there is another pressing issue that you didn't mention, I am not sure that you need a stress test at this time.
3D echo is more of research tool now. 2D echo is just fine for the procedure.
I hope this answers your questions. good luck and thanks for posting.
I did have both Echo stress followed some months later by the Dobutamine but saw very little differences except that the Dob gave me severe flushing and palps effects. I also think that the Echo stress is better once you can tolerate it. I also have some persistent chest discomfort with nausea so may eventually have to do an Angio. Will appreciate your comments on the meds and wish you all the best.