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To demonstrate the value of stress echocardiography after myocardial infarction, findings are presented for a patient who experienced an anterior wall infarction: apical dyskinesia is present at rest. During pharmacological stress testing (infusion of dobutamine), the four-chamber view shows an increase in contractility mediobasally, with dyskinesia persisting at all times in the apical region. The finding can be interpreted as showing that ischemia cannot be detected in the previously uninfarcted myocardium and the infarcted myocardium shows predominant areas of scarring (negative proof of viability).
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