Pharmacologic-stress-test

• Use if unable to exercise, low exercise tolerance, or recent MI. Se & Sp ≈ exercise.

• Preferred if LBBB, WPW or V-paced, because higher prob of false ⊕ imaging with exercise

• Coronary vasodilator: diffuse vasodilation → relative perfusion defect in vessels w/ fixed epicardial disease. Reveals CAD, but not if Pt ischemic w/ exercise. Regadenoson (↓ side effects), dipyridamole, adenosine. Side effects: flushing, ↓ HR, AVB, SOB, bronchospasm.

• Chronotropes/inotropes (dobuta): more physiologic, but longer test; may precip arrhythmia