These are systolic still-frames of a dobutamine stress echocardiogram in our patient. The two resting images are on the left and the two stress images are on the right. The two parasternal long axis views are at the top and the two short axis views are at the bottom. Note especially left ventricular chamber size. In the resting images, shown on the left, the left ventricular cavity in systole is smaller than it is during stress, shown on the right. This is true in both the long and short axis views and is clearly abnormal. It is due to myocardial ischemia during stress. In the real time study that follows, note especially the abnormal motion of the septum and anterior wall in the resting images on the left, as compared to the reduced motion in the stress images on the right.
Our patient's stress echo - discussion
Our patient's stress echocardiogram clearly shows changes consistent with marked ischemia of the anterior wall and septum. These findings suggest that significant obstruction in the left coronary system. The patient was taken to the cardiac catheterization laboratory for further study.