The place of echocardiography with physical activity in the diagnosis of stable coronary heart disease: state of the art

Ischemic heart disease is the most common cause of death in developed countries. Diagnostic methods for ischemic heart disease can be classified into functional (stress tests: echocardiography with physical or pharmacological stress, perfusion myocardial scintigraphy with physical or pharmacological stress, magnetic resonance imaging of the heart with physical or pharmacological stress) and imaging (computed tomographic coronary angiography and selective coronary angiography) methods. An algorithm has been developed for assessing the pretest probability of coronary heart disease, according to the clinical picture of the disease, complaints, age and sex of the patient that simplifies the procedure for making a decision regarding the diagnostic method. As per the data from previous studies, stress tests have shown comparable sensitivity and specificity, making it possible to choose a diagnostic method based on other factors, such as method safety, operator dependence, physiology and availability. This study focuses on stress echocardiography as the safest and most affordable diagnostic method. We present an algorithm for performing echocardiography with exercise as per the data from European and national Russian guidelines.