Sunday, October 26, 2008
Dobutamine Stress ECHO (We Call It DSE for short)
I may confuse all of you again with some of the medical terms in this entry but don't worry , i will make easy for you to understand....yeah and this entry is not about makan makan but an entry which requires skill and your experienced interpretation.
You probably read our Dr. Shah's blog regarding his Exercise Stress Test (EST) which requires one to walk in different stages and the ECG tracings will then show wether the test renders a positive or negative outcome. Similarly, DSE (Dobutamine) stress ECHO is a functional study whereby we resort it to people who has inconclusive EST or patients who basically cannot run for example they have knee problems or neurological problems and etc. Dobutamine infusion helps to increase your heart rate to mimic the exercise actually..and even we inject bolus of Atropine if the target heart rate is not achieved. In addition, during the test, we observe the ECG tracings and the Echocardiography (Heart Ultrasound) to see any wall proportionate augmentation. We need to take heart moving pictures during baseline, low dose, peak dose and resting/ recovery period and it usually takes about 30 to 45 minutes per patient. My interpretation has to be certified by my consultant first before i report it on paper.
DSE helps to diagnose/suggest coronary artery disease (yeah..angiogram still a golden method), viability study before deciding bypass is a good option in severe heart disease with poor heart contractily or either a vessel has added benefit for angioplasty (coronary stenting)
Picture above : i was doing DSE for a diagnostic purpose....CAN YOU GUESS THE MACHINE PRICE ????(clue : very expensive !! ha ha ha)
Talking about sub-cardiology specialties : we branch into ; EPS study , cardio imaging (eg . cardiac MRI, MSCT), Peripherals, non-interventional, heart failure and etc.... And insyaAllah...my interest will be in heart failure therapy whereby one has to deal with chronic heart failure management, ICD's, heart and lung transplant options ...etc ..and i think this field is very challenging and i love challenge but yeah..it is a long long way to go...