DIPYRIDAMOLE STRESS ECHOCARDIOGRAPHY - STATE-OF-THE-ART 1996

Dipyridamole stress is the forerunner and prototype of pharmacological stress echo tests in the diagnosis of coronary artery disease. Among the various stress echo tests, it is probably the least technically de manding to perform and the easiest to interpret. Its accuracy is simil ar to dobutamine stress echocardiography but its feasibility is higher . The prognostic impact of dipyridamole stress echo has also been prov en for presentation of hard end-points such as cardiac death. The safe ty and prognostic value of this test has been conclusively demonstrate d as a result of extensive experience in large scale multicentre proje cts. Dipyridamole stress is many different tests in one: dipyridamole- atropine is best for diagnosis; dipyridamole-dobutamine ol dipyridamol e-exercise is highly sensitive for the detection of minor forms of cor onary artery disease; low and high dose dipyridamole is best suited fo r prognostic stratification; infra-low dipyridamole with low dose dobu tamine administration is probably best suited for selective myocardial viability identification. Each patient should have their own test, ta ilored on the basis of the clinical picture and the diagnostic issue.