Andrea de Andrade Vilela et al. Maria Estefania Otto Gustavo Nishida Jorge Eduardo Assef
Abstract
Cycle ergometer stress echocardiography is an important technique to provides information of cardiac chambers dynamics and cardiovascular hemodynamics during exercise. This method identifies patients who present hemodynamic congestion during exertion, assessment of different causes of dyspnea, through the analysis of diastolic filling pressures and pulmonary artery systolic pressure. Recently, with the incorporation of lung ultrasound, it was possible to add the pulmonary congestion parameter with the identification of the appearance of “B” lines during the exam, increasing the sensivity of the protocol.
However, Cycle ergometer stress echocardiography is still little used in our country. This reality is probably due, in part, to the need for appropriate training of the medical and nursing staff; in addition to the lack of knowledge of the method among the medical community, which rarely requests this test for hemodynamic assessment and research into exertional dyspnea. Therefore, the objective of this document is not only to disseminate the method, but also to describe in a practical and didactic way the step-by-step hemodynamic evaluation of the echocardiogram with physical stress on a Cycle ergometer. We suggest a protocol that is easy to apply and capable of distinguishing between the findings of patients with normal hemodynamics and those with an inappropriate hemodynamic response to physical effort. Additionally, two clinical cases are reported with multiple images and hemodynamic changes, with a description of the correct interpretation of the findings to better understand the method and its diagnostic capacity.