Transoesophageal stress echocardiography.

Transoesophageal echocardiography has been performed in conjunction with pacing, dobutamine, or dipyridamole stress to detect stress-inducible ischaemia, and has proved to be a highly accurate diagnostic tool. Its advantages of improved image quality and high diagnostic accuracy have to be weighed against the disadvantages of semi-invasiveness and patient discomfort. The existing data on this stress echo modality and on special applications (diastolic dysfunction, ischaemic mitral regurgitation, hibernating myocardium, peri-operative risk assessment) are reviewed.