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Stress echocardiography means a pair of cardiac ultrasound imaging examinations, before and after exercise. I assume that coronary blood flow is increased after exercise. Is cardiac ultrasound technology capable of showing this blood flow difference?

Update: I emphasize that my question concerns stress echocardiography, i.e. two echocardiography sessions before and after exercise (or pharmacological stress test) - not simply echocardiography.

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No, echocardiography is not sensitive enough to do so. For tracing coronary arteries directly flow angiography is the choice.

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  • $\begingroup$ To a related question of mine AndroidPenguin yesterday answered that with stress echocardiography we could "see how it responds to increased exercise (does the blood flow increase by the same amount everywhere?)". Was AndroidPenguin wrong? $\endgroup$
    – winerd
    May 21, 2013 at 15:29
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Coronary artery disease thickens the wall. Flow is dramatically affected by thickness (radius to the fourth power). In an echo you observe the heart muscle i.e. does it contract normally using the surrounding muscle and baseline as a comparison. If the wall is thickened, this will cause a decrease in perfusion which will result in the heart muscle contracting abnormally. Xaqron is right, it doesn't show you flow directly, but what it does show you is a quick and cheap way to estimate if the artery is blocked enough that it will cause a noticeable difference. If the heart muscle doesn't beat that means it really isn't getting oxygen (but could be because of abnormal conduction), and if it beats suboptimally it is getting less oxygen than it requires.

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