NBE Stress Echocardiography 3

Question 1

Which stress echocardiography protocol uses a staged infusion starting at 5 mcg/kg/min and increasing to a maximum of 40 mcg/kg/min?

Accepted Answer

Standard dobutamine stress echocardiography (DSE) protocol

Answer

The standard DSE protocol begins at 5 mcg/kg/min and increases in 3-minute stages to 10, 20, 30, and 40 mcg/kg/min, with atropine added if needed.

Question 2

During stress echo, a segment that is normokinetic at rest becomes akinetic at peak stress and does NOT recover. This pattern is most consistent with:

Accepted Answer

Inducible ischemia without viability concern

Answer

New akinesis at peak stress without recovery represents inducible ischemia in presumably non-hibernating myocardium, indicating significant coronary artery disease.

Question 3

What is the target heart rate for dobutamine stress echocardiography?

Accepted Answer

85% of age-predicted maximum heart rate (220 minus age)

Answer

The target heart rate for DSE is 85% of the age-predicted maximum heart rate (220 minus age), consistent with standard stress testing endpoints.

Question 4

Which condition is a contraindication to dobutamine stress echocardiography?

Accepted Answer

Severe hypertrophic obstructive cardiomyopathy (HOCM)

Answer

Severe HOCM is a contraindication because dobutamine increases contractility and heart rate, which can dramatically worsen outflow tract obstruction and cause hemodynamic compromise.

Question 5

In a patient undergoing pharmacological stress echo with vasodilators (adenosine or dipyridamole), what is the mechanism of detecting ischemia?

Accepted Answer

Coronary steal phenomenon causing relative hypoperfusion in diseased territories

Answer

Vasodilators cause maximal dilation in normal coronary arteries, creating a 'steal' that diverts blood away from territories supplied by stenotic vessels.

(NBE) National Board of Echocardiography Practice Test

(NBE) National Board of Echocardiography Practice Test

NBE Stress Echocardiography 3