Alternative names

Echocardiography stress test; Stress test - echocardiography

Definition

Stress echocardiography is a test that helps diagnose blocked arteries (ischaemic heart disease) with the help of ultrasound images. (A more routine exercise stress test does not use imaging.) There are two ways in which a stress test can be performed. One way involves stressing the heart by exercising on a treadmill followed by performing an echo to diagnose blockages. This is particularly useful if the patient is fit to exercise. The second method is useful in patients who cannot exercise because of frailty or arthritis, etc. and involves giving a special drug (dobutamine) given through an intravenous cannula to exercise the heart. For this test, the patient does not have to exercise, but lies on the bed whilst echocardiogram images are acquired during the infusion. Following exercise the echocardiogram images reveal parts of the heart that may not be receiving enough blood or oxygen because of blocked arteries.

This test may be used to monitor your progress if you already have a known heart condition.

How the test is performed

The ultrasound portion of this test is performed in the same way as an echocardiogram. Exercise (treadmill/bicycle) or medication is used to increase your heart rate and show how your heart works under exertion.

How to prepare for the test

• DO NOT eat or drink for at least 3 hours before the test.
• Ask your cardiologist if you should take any of your routine medicines on the day of the test (especially if you are taking heart medication).
• Wear loose, comfortable clothing.
• You will be asked to sign a consent form before the test.

How the test will feel

A stress or dobutamine echocardiogram includes the following steps:

• A resting echocardiogram will be performed.
• You will exercise or be given medicine until you reach the target heart rate.
• Your blood pressure and heart rhythm (ECG) will be monitored throughout the procedure.
• A videotape of the ultrasound images will be taken during the procedure.
• Another echocardiogram will be taken immediately after your target heart rate has been achieved. With the dobutamine test, images are acquired every 3 minutes during the test.

Why the test is performed

The test is performed to see whether your heart is getting enough blood flow and, therefore, enough oxygen when it is put under stress. The intent is to discover and treat any blockage or disease before serious or life-threatening problems develop.
What the risks are

The risks are very low, and the doctor and/or nurse will monitor you during the entire procedure. Rare complications include abnormal heart rhythm, heart attack, and collapse.

Special considerations

The main benefit is that a stress echocardiogram is a very effective, noninvasive test that can help determine whether you have blockages in your coronary arteries and if so, how serious the problem is. Early diagnosis and monitoring of heart disease allows treatment to begin early.

For patients who have already been diagnosed with coronary artery disease, this test can show whether your heart's function and blood flow are stable, or if blood flow to additional areas of your heart has become blocked.

Update Date: 11/7/2006

Updated by: Glenn Gandelman, MD, MPH, Assistant Clinical Professor of Medicine, New York Medical College, Valhalla, NY. Review provided by VeriMed Healthcare Network.