Dobutamine stress echocardiography (DSE) can be performed safely at the bedside and offers more immediate results and lower cost than other pharmacologic imaging methods. Applications in the intensive care unit include detection of coronary artery disease and assessment of myocardial viability. DSE is also a useful adjunctive study for examining valvular function or revealing obstructive cardiomyopathy. Dobutamine infusion is started at 5 mug/kg/min and peaks at 40 or 50 mug/kg/min. Four standard echocardiographic views are used to show left ventricular wall segment responses; both the extent of thickening and type of motion are assessed.