Stress-echocardiography represents a new non-invasive, alternative approach in the assessment of patients with coronary artery disease. By means of dynamic or pharmacological stress or by atrial pacing regional wall motion abnormalities can be induced, which can be identified by 2D-echocardiography. Beyond the indirect detection of ischemia this approach allows a better quantification of the amount of ischemia and of global LV function, which is advantageous compared to stress ECG recording or myocardial scintigraphy. Disadvantageous is however, the subjective reading of the echo itself. In experienced hands stress-echocardiography has proven to be as sensitive and specific as myocardial scintigraphy. Recently, in addition the diagnostic potential of myocardial cell injury has been improved by the detection of specific antibodies versus Troponin T. In comparison with conventional biochemical markers of myocardial cell necrosis Troponin T analysis has been proven to be superior in postoperative or traumatic cardiac damage or in the setting of acute myocardial infarction. In this situation the time window is improved by an earlier rise compared to CK and a longer detection rate compared to lactate dehydrogenase.