Pharmacological Methods Instead of Exercise for the Assessment of Coronary Artery Disease

Due to new knowledge of pathophysiology, diagnosis, and treatment, the clinical approach to the patient with suspected coronary artery disease has deeply changed over the last few years. The central role of functional factors‐independent from or in association with organic stenosis‐are important in the genesis of myocardial ischemia. On the diagnostic side, the widespread use of new methodologies permits detection of ischemia by means of perfusion, mechanical, and metabolic markers. Drugs such as beta blockers, nitrates, and calcium antagonists, and procedures such as coronary angioplasty, have fostered a new era in which it is crucial not only to document ischemia, but also to understand the underlying mechanism. The present article deals with the most important pharmacological tests that can fit into a modern approach to noninvasive ultrasonic diagnosis of coronary artery disease. (ECHOCARDIOGRAPHY, Volume 8, January 1991)