Pharmacologic Stress Testing

For many patients, exercise stress testing is the preferable mode of physiologic stress testing, as it offers insight into functional capacity and assessment of symptoms. However, in situations when a patient cannot exercise, reach target heart rate response, or has a contraindication to exercise stress testing, pharmacologic agents may be used in conjunction with myocardial perfusion imaging to assess symptomatic patients with known or suspected coronary artery disease. Pharmacologic stress testing can be done using vasodilator stress with three available agents: adenosine, dipyridamole, or regadenoson or by catecholamine stress using one agent: dobutamine. Data indicate diagnostic accuracy to be similar to exercise imaging.