To understand the pathophysiological basis for stress echocardiography as a diagnostic tool for the evaluation of native valve disease.
To appreciate the methodological considerations and individualised protocols for stress echocardiography in each type of valve lesion.
To recognise the role of stress echocardiography in clinical decision making and prognosis with reference to guidelines for indications of stress echocardiography and management of valve disease.
Stress echocardiography is an established technique for the detection of coronary artery disease, but the echocardiographic assessment of valve disease has conventionally been performed under static conditions. However, valve disease also tends to present with exertional symptoms, influenced by changes in haemodynamic conditions provoked by normal physical activity. The changes in heart rate, contractility, loading conditions and left ventricular (LV) compliance during exercise may influence the haemodynamic significance of a given valve lesion. Consequently, in recent…