应力超声心动图

定义

应力超声心动图 is a test that uses ultrasound imaging to show how well your heart muscle is working to pump blood to your body while you exercise in a controlled setting. It is most often used to detect a decrease in blood flow to the heart muscle due to 冠状动脉变窄.

选择的名字

超声心动图 stress test; Stress test - echocardiography; CAD - stress echocardiography; Coronary artery disease - stress echocardiography; Chest pain - stress echocardiography; Angina - stress echocardiography; Heart disease - stress echocardiography

如何执行测试

This test is done at a medical center or health care provider's office.

一个休息 超声心动图 会先完成. While you lie on your left side with your left arm out, a small device called a transducer is held against your chest. A special gel is used to help the ultrasound waves get to your heart.

Most people will walk on a treadmill (or pedal on an exercise bicycle). Slowly (about every 3 minutes), you will be asked to walk (or pedal) faster and on an incline. It is like being asked to walk fast or jog up a hill.

在大多数情况下, 你需要步行或骑车5到15分钟, 这取决于你的健康水平和年龄. 您的十大赌博平台排行榜会要求您停止:

• 当你的心脏以目标速率跳动时
• 当你累得无法继续的时候
• If you are having chest pain or a change in your blood pressure that worries the provider administering the test

如果你不能锻炼, 你会得到一种药, 比如多巴酚丁胺, 通过静脉(静脉注射线). This medicine will make your heart beat faster and harder, similar to when you exercise.

Your blood pressure and heart rhythm (ECG) will be monitored throughout the procedure.

More 超声心动图 images will be taken while your heart rate is increasing, 或者当它达到顶峰的时候. The images will show whether any parts of your heart muscle do not work as well when your heart rate increases. This is a sign that part of the heart may not be getting enough blood or oxygen because of narrowed or blocked arteries.

如何准备考试

Ask your provider if you should take any of your normal medicines on the day of the test. 有些药物可能会影响检测结果. Never stop taking any medicine without first talking to your provider.

It is important to tell your provider if you have taken any of the following medicines within the past 24 hours (1 day):

• 柠檬酸西地那非(伟哥)
• 他达拉非(西力士)
• 伐地那非(血管扩张药)

DO NOT eat or drink for at least 3 hours before the test.

穿宽松、舒适的衣服. You will be asked to sign a consent form before the test.

考试的感觉如何

Electrodes (conductive patches) will be placed on your chest, 武器, 还有腿来记录你的心脏活动.

The blood pressure cuff on your arm will be inflated every few minutes, 产生一种挤压感，可能感觉很紧.

考试期间, 人们感到胸部不适, 心跳多余或跳过, 头晕, 头疼, 恶心想吐, 或者呼吸短促. Be sure to tell the person doing the test if you feel any of these symptoms.

为什么要进行测试

The test is performed to see whether your heart muscle is getting enough blood flow and oxygen when it is working hard (under stress).

如果您:

• 有心绞痛或胸痛的新症状
• 心绞痛越来越严重
• 最近有心脏病发作吗
• Are going to have surgery or begin an exercise program, if you are at high risk for heart disease
• 心脏瓣膜有问题

The results of this stress test can help your provider:

• Determine how well a heart treatment is working and change your treatment, if needed
• 确定你的心脏跳动的情况
• 诊断冠状动脉疾病
• 看看你的心是否太大了

正常的结果

A normal test will most often mean that you were able to exercise as long as or longer than most people of 你的年龄 and sex. You also did not have symptoms or concerning changes in blood pressure and your ECG. Your heart pictures show that all parts of your heart respond to increased stress by pumping harder.

A normal result means that blood flow through the coronary arteries is probably normal.

The meaning of your test results depends on the reason for the test, 你的年龄, and your history of heart and other medical problems.

异常结果意味着什么

异常结果可能是由于:

• 心脏某部分的血流量减少. The most likely cause is a narrowing or blockage of the arteries that supply your heart muscle.
• Scarring of your heart muscle due to a past heart attack.

测试后，您可能需要:

• 血管成形术和支架置入
• 心脏药物的变化
• 冠状动脉造影
• 心脏搭桥手术

风险

风险很低. Health care professionals will monitor you during the entire procedure.

罕见的并发症包括:

• 心律失常
• 晕倒(晕厥)
• 心脏病

参考文献

博登我们. 心绞痛和稳定型缺血性心脏病. 见:高德曼L，库尼KA，编. Goldman-Cecil医学. 27日,艾德. Philadelphia, PA: Elsevier; 2024:chap 56.

傅国强，张国强. 应力超声心动图. 见:福勒GC编. 芬宁格和福勒的初级保健程序. 第四版. Philadelphia, PA: Elsevier; 2020:chap 76.

李建军，李建军. 应力超声心动图 for detecting coronary ischemia. 见:奥托·CM主编. 临床超声心动图实践. 6日艾德. Philadelphia, PA: Elsevier; 2022;chap 19.

范德毕杰，陈建军，陈建军. Nonexercise stress echocardiography for the diagnosis of coronary disease. 见:奥托·CM主编. 临床超声心动图实践. 6日艾德. Philadelphia, PA: Elsevier; 2022:chap 20.

Virani SS, Newby LK, Arnold SV，等. 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the management of patients with chronic coronary disease: A report of the American Heart Association/American College of Cardiology joint committee on clinical practice guidelines. 循环. 2023;148:e9–e119. PMID: 37471501 pubmed.ncbi.nlm.美国国立卫生研究院.gov / 37471501 /.

吴建军，吉兰LD，所罗门SD，布尔沃B. 超声心动图. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12日艾德. Philadelphia, PA: Elsevier; 2022:chap 16.