Stress Echocardiographic Study

A major goal of noninvasive stress testing (e.g. treadmill testing, stress echocardiography) is to identify a person who is at high risk for experiencing sudden cardiac death or a heart attack. The individual may be in one of three categories:

  • Asymptomatic
  • Angina (exertional chest discomfort, shortness of breath, or fatigue)
  • Known to have coronary artery disease
  • Prompt identification of a high-risk individual provides the person with the opportunity to immediately lower one’s risk by undergoing coronary revascularization (restoration of blood flow to the area of heart muscle beyond a blockage) through coronary stenting with a success rate of 97-99%. Nowadays, it is much less common for an individual to undergo coronary artery bypass surgery.

Conversely, a person deemed to be at low risk or low to intermediate risk for subsequent cardiac events based upon stress test findings can be spared premature referral for coronary angiography (heart catheterization procedure that clearly defines one’s coronary anatomy in order to determine whether significant blockage is present).

Modern aggressive medical therapy is highly effective in reducing plaque burden (decreasing the volume of cholesterol within the coronary artery plaque). As such, medications, prudent dietary measures, and daily aerobic exercise have been shown slow down the progression, and many times, prevent the progression of atherosclerotic disease (presence of plaque in the arterial system). A balanced approach (using all three therapeutic modalities), dramatically reduces one’s risk of plaque rupture and thereby markedly diminishing the likelihood of experiencing a heart attack, stroke, or sudden cardiac death. Anti-atherosclerotic therapy (e.g., lipid lowering medications, diet, exercise), together with anti-ischemic therapy (medications that reduce the workload of the heart and/or increase collateral blood flow to the affected region of the heart muscle beyond the blockage), can stabilize patients who do not have high-risk disease (e.g., enlarged or weakened heart, left main coronary artery disease).

Exercise stress testing provides the individual with the opportunity to have a physiologic cardiovascular evaluation whereby risk assessment takes place in a controlled environment. It allows Dr. Scuderi to more precisely evaluate the probability of having significant underlying coronary artery disease. The following variables are predictive of high risk for coronary artery disease:

  1. Ischemic ST-segment depression > 2.0 mm
  2. Ischemic ST-segment depression appearing at low heart rate/workload
  3. Ischemic ST-segment depression lasting > 5 minutes in recovery phase
  4. Small change in heart rate from rest to peak exercise
  5. Blunted systolic blood pressure response
  6. Achieve < 6 MET workload
  7. Exercise-induced ventricular tachycardia
  8. Abnormal heart rate decline in recovery phase

The most important of the variables is low workload achieved and ischemic ST-segment depression appearing at low heart rate or low workload. These variables are synergistic; when two or more occur, the risk of coronary artery disease increases exponentially.

CardioFit Wellness Institute is designed and operated to identify and treat cardiovascular conditions in a proactive manner by identifying cardiovascular conditions before disability or death occurs unnecessarily. Life is precious and tenuous at times. Dr. Scuderi has treated tens of thousands of patients over his career and frequently identifies individuals at risk that, if it were not for his proactive, streamlined approach in rendering the necessary care, hundreds of these individuals would not have been alive in the hours to days that followed. The human suffering that occurs when you or a loved one dies of sudden cardiac death is far greater than one realizes as we go about the routines of our day. The impact of this loss of life is indeed dramatic and manifold.

Dr. Leonard J. Scuderi is a uniquely qualified cardiologist with over 20 years of expertise in preventive cardiology as well as interventional cardiology (coronary stenting, pacemaker implantation, etc.). He is also founder/CEO of CardioFit Wellness Institute. He is also the medical director of CardioFit Echocardiographic Laboratory. This on-site diagnostic imaging center features the most advanced, state-of-the-art technology in the world; the Philips iE33 three-dimensional (3-D) stress echocardiographic machine is unparalleled in imaging quality and provides noninvasive ultrasonic renderings of the heart that are astonishing. There is no radiation exposure or lengthy waiting times required to accomplish the very finest diagnostic testing available. Your safety and time are of prime concern to us at CardioFit.

In the area of risk stratification discussed above, Dr. Scuderi continues to be a leader in the field and applies his personalized approach to cardiovascular care of each and every one of his patients. He has a unique way of empowering his patients by educating them about their condition(s) and helping them to take outstanding care of their entire cardiac and circulatory systems. It is through education, dedication, and establishing a sound relationship between you and your cardiologist that this level of achievement is made possible. It requires a commitment between both individuals.

Dr. Scuderi and his premier staff at CardioFit Wellness Institute are willing and highly capable of being your partner in achieving and maintaining the finest cardiovascular health. If you would like to have the opportunity of receiving a personalized cardiology consultation and becoming a patient of Dr. Scuderi, please call 310-791-5577 between 7:30 a.m. and 5:00 p.m. Monday through Thursday.

Premier members of his practice are provided direct access to him through his own cell phone number 24/7. All of Dr. Scuderi’s patients may reach him 24/7 by calling 310-791-5577, entering 105 (once the voice message has begun), and leaving a brief message including your name and phone number. Your call will be returned by Dr. Scuderi within several minutes.