Stress Echocardiography: A Historical Perspective (or, How I Ate My Father)
As happens with any scientific innovation, stress echocardiography completed its life cycle by moving from the status of “promising innovation”, used by a few enthusiastic supporters amid general skepticism, up to the rank of “established technology” accepted by virtually the whole cardiological community (Fig. i) — sometimes even overused, with an embarassing lack of common sense tending to transform the technique into a totem — whose responses, taken out of the overall clinical context, may produce more problems than solutions in patient management. The impressive increase in the amount of editorial space devoted to stress echo in major journals and meetings testifies to its increased acceptance by cardiologists (Fig. 2). Ten years ago, stress echo was a scientific fact without clinical substance: an academic somersault in front of empty seats. At present, the real risk for stress echo is to become a clinical fact without scientific substance: all laboratories do stress echo, but often in the wrong way and/or with inappropriately selected patients.
KeywordsNuclear Cardiology Stress Echocardiography Pharmacological Stress Variant Angina Established Technology
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