User Guide

Getting started with DSE123

DSE123 guides you through the complete dobutamine stress echocardiography workflow in six simple steps. Everything runs in your browser — no accounts, no cloud storage, no patient data leaves your device.

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Step 1.Enter Patient Info

Start by entering basic patient demographics: name, age, sex, height, weight, and BSA. These values are used to index hemodynamic calculations and are included in the final report.

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Step 2.Select Protocol

Choose your stress protocol based on the clinical indication. Options include standard dobutamine stress (ischemia assessment), low-dose viability protocol, and low-flow low-gradient (LFLG) aortic stenosis evaluation. Each protocol adjusts stages, dosing, and target parameters automatically.

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Step 3.Configure Syringe

Set up the dobutamine infusion parameters: drug concentration, syringe volume, and the patient’s weight-based dosing. The app calculates the infusion rate for each protocol stage automatically.

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Step 4.Record Per-Stage Data

At each protocol stage, record echocardiographic measurements including wall motion scores, LVOT VTI, aortic valve gradients, heart rate, and blood pressure. The app tracks changes across stages and flags significant findings in real time.

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Step 5.Complete the Study

Once all stages are recorded (or the test is terminated early for clinical reasons), review the summary dashboard. The app compiles all stage data, calculates derived parameters, and presents a comprehensive overview of the study findings.

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Step 6.Generate Report

Generate a structured PDF report directly in your browser. The report includes patient demographics, protocol details, per-stage measurements, hemodynamic calculations, wall motion analysis, and clinical interpretation. Download or print the report for your records.

⚡Emergency Medication Assistant

A floating button at the bottom-left of the screen gives you instant access to weight-based IV drug dosing tables for emergency medications commonly used during stress echocardiography.

Supported medications include:

Atropine — fixed 0.6 mg dose increments
Metoprolol — 5 mg / 5 ml IV bolus dosing
Esmolol — loading dose + continuous infusion calculated in mg/min
Amiodarone — 150 mg bolus + 900 mg / 50 ml syringe pump infusion

Once the patient’s weight is entered, all doses auto-adjust accordingly and the pill automatically collapses to a compact circle for an unobtrusive experience.

📊ECG ST-T Morphology

The ECG ST-T dropdown in the monitoring table now includes specific ST Depression subtypes to improve diagnostic precision:

Horizontal and Downsloping — strong indicators of myocardial ischemia
Upsloping — generally a benign response to exercise or stress

The auto-generated conclusion intelligently narrates these findings:

Horizontal / Downsloping → “Ischemic ECG changes noted at [dose] µg/kg/min”
Upsloping → “Non-specific ST changes — not diagnostic for ischemia”
T-wave inversions and arrhythmias are also captured automatically

These morphology options apply to both Ischemia and Viability protocols.

🤖Smart Auto-Conclusion

After selecting a DSE Result (Positive, Negative, or Equivocal), a comprehensive conclusion paragraph is automatically generated based on the study data.

The auto-conclusion incorporates: adequacy (APMHR%), pharmacology (dobutamine dose and atropine usage), symptoms, ECG changes (with ST morphology detail), regional wall motion abnormalities with coronary territory mapping, and termination events.

The generated text is fully editable — review and modify the conclusion before exporting. It also live-syncs with all inputs: changing ECG findings, RWMA data, or symptoms will automatically update the conclusion in real time.

📝Additional Notes

A free-text notes field is available in the Intra-Procedural Log for documenting clinical observations, patient response, or any specific details relevant to the study.

These notes are included in the exported PDF report under a dedicated“Additional Notes” section, ensuring all clinical context is preserved in the final documentation.

🔒Privacy & Data

DSE123 is designed with a privacy-first architecture. All data entry, calculations, and report generation happen entirely in your browser. No patient information is ever sent to any server. When you close the tab, all entered data is discarded. PDF reports are generated client-side and saved directly to your device.

We use anonymous, cookie-free analytics (Vercel Analytics) solely to understand aggregate usage patterns. No personal or clinical data is collected.

🎯Demo Mode

DSE123 includes a built-in demo mode for training and exploration. To activate pre-filled sample data, enter one of the following keywords in the patient name field:

TEST POSITIVE

Simulates a positive ischemia study

TEST NEGATIVE

Simulates a negative ischemia study

TEST VIABILITY

Simulates a viability assessment

TEST LFLG

Simulates a low-flow low-gradient AS study

Demo mode pre-fills all stages with realistic sample data, allowing you to explore the full workflow, calculations, and report generation without entering real patient data.

📬Need Help?

If you encounter any issues, have feature suggestions, or need assistance using DSE123, please reach out:

Dr. Kunal Patankar
Visit our Contact page or email us directly at drkunalpatankar@gmail.com

Check out our Changelog to see the full version history and community contributions.