Stress Echocardiogram
A stress echocardiogram (sometimes called "stress echo") is a tool used to evaluate heart function by combining an exercise (stress) test or pharmacologic
("chemical") stress test with a transthoracic (through the chest) echocardiogram. A stress echocardiogram uses ultrasound waves to produce images of the
heart both before (sometimes during) and immediately following exercise. Images of the heart at rest are compared with images of the heart during and/or
after stress to evaluate how the heart responds to stress.
What is the purpose of stress echocardiography?
As activity increases during the test, or as medication that simulates exercise is given through an IV, more oxygen is needed and the heart responds by
pumping more blood. This test can show if there is reduced blood flow in the arteries that supply the heart. It also helps doctors learn the limitations
of exercise appropriate for each individual patient. Sometimes, arrhythmias can be detected during exercise. Other possible objectives of stress
echocardiography may include:
- Diagnosing blockages in heart arteries
- Following the status or progression on known heart artery blockages
- Determining the pumping function of the heart
- Determining the severity and significance of heart valve problems
- Determining prognosis
- Determining limitations to exercise for rehabilitation or exercise programs
- Determining whether exercise induces a heart rhythm problem
- Determining whether blood oxygen level drops during exercise
Are there forms of stress other than exercise?
For patients who cannot exercise on a treadmill or stationary cycle, there are medications that your doctor can give you intravenously (through an IV) to
"simulate exercise". The most commonly used medication with echocardiography is dobutamine. Dobutamine is also used for improving the functioning of a
failing heart. In stress testing, dobutamine produces changes similar to exercise - increase in heart rate and cardiac output. In this manner, it stresses
the heart and may demonstrate limitations in blood flow during stress.
What happens during a stress echocardiogram?
- You will be given a hospital gown and asked to remove clothing from the waist up.
- An (ultrasound technician) sonographer will place electrodes on your chest to monitor your electrocardiogram (ECG). The electrodes are small, circular
pads with a sticky substance to help them adhere to the skin.
- Your blood pressure and ECG will be monitored throughout the test.
- You will be asked to lie on your left side on an exam table. The sonographer will place a wand (the ultrasound transducer that directs the sound waves)
on different areas of your chest. To facilitate movement on your skin, a small amount of gel is placed on the end of the wand.
- An intravenous line (IV) may be inserted into a vein in your arm so the dobutamine medication can be delivered directly into your bloodstream if you are
having a chemical stress test rather than exercise on a treadmill.
- Your doctor will begin the treadmill or the infusion of dobutamine into the IV while the ultrasound technician continues to record echo images. The
medication will cause your heart to react as if you were exercising.
- The dobutamine may give you a warm, flushing feeling and some patients experience a mild headache.
- Throughout the test, your doctor and the ultrasound technician will ask how you are feeling. Be sure to tell them if you feel chest, arm or jaw pain or
if you are, short of breath, dizzy or feel lightheaded.
- The IV line will be removed from your arm once all of the medication has entered your bloodstream.
What is contrast echocardiography?
Occasionally the ultrasound pictures are not a clear as needed for an adequate stress test. Contrast echocardiography combines an echocardiogram with an
administration, through a vein, of a sterile contrast solution, which allows visualization of the inside of the heart. You will need to have an IV started
to receive a contrast echocardiogram. Side effects of contrast are rare.
Will I feel any pain or discomfort during the test?
- There's very little risk for healthy patients in taking the test - no more than if you were to walk fast or walk up stairs.
- A blockage in a heart artery could cause chest pain or shortness of breath. · Medications may cause shortness of breath, chest discomfort, nausea,
headache, or tingling.
- The adhesive on electrodes may cause minor skin irritation.
How long does the test take?
Preparation, performance of the test, and completion of the test generally takes about an hour. The length of the actual stress test depends on how long
you can go on the treadmill or how long it takes the medication to have adequate effect on the heart to "simulate exercise." Your age, physical
conditioning, and medical limitations are all factors in the amount of time required to complete the test.
How do I get the results of my stress echocardiogram?
After the doctor interprets the test, a report will be sent to your primary care physician. If the test was ordered as part of your cardiologist's care,
he/she typically will have told you during your appointment whether you will have a follow-up appointment to discuss results or whether you will receive a
call or letter. Unless an appointment has been made for you, please call our office if you have not received the results within 10 business days.
