We prospectively studied the feasibility and safety of high-dose dipyridamole echocardiography in 166 patients (77 younger and 89 elderly patients) referred for clinical evaluation of coronary artery disease. The feasibility of dipyridamole echocardiography test was 80.5% in the young and 82% in the elderly (p = n.s.). The incidence of side effects during dipyridamole echocardiography was similar in two groups, except for dyspnea which was observed in 20% in the older and 4% in the younger (p < 0.01). Our data demonstrate that the dypiridamole test combined with echocardiographic monitoring of regional myocardial contractility may be considered a valid non invasive method for evaluating coronary artery disease in the elderly.