Stress Echocardiogram

This test can be used to detect if there are blockages in the arteries of the heart. It can also be used to evaluate the heart’s ability to properly increase the rate of contraction under stress in patients with slow heart rates. Additionally, it can be used to evaluate of patients with valve disease to see if they are symptomatic. It also provides prognostic information by evaluating a patient’s exercise capacity, how their blood pressure reacts to exercise, and how their heart rate recovers from exercise. In essence, this test includes all of the information that is provided by a stress EKG.

This test is useful in that it can provide structural information about the heart, such as how well the walls of the heart move and how the valves of the heart function in addition to evaluating for blockages in the arteries.

We offer this test at all of our AdventHealth hospitals as well as our Lansing clinic. Please arrive 15 minutes before your test is scheduled to allow for check in. The procedure will take approximately 90 minutes.

A specially trained cardiac sonographer will start by doing a partial transthoracic echocardiogram. Some patients might need contrast in order to obtain better quality images. If this is the case, then you will get an IV in order to administer the contrast. Afterwards a nurse will place 10 electrode patches on your chest and attach them to a machine to record your EKG. You will have somebody monitoring your EKG and monitoring you for concerning symptoms.

During the test you will be asked to walk on a treadmill following a standard protocol known as the Bruce protocol. The protocol starts at a slow speed and low level of incline. The treadmill speed and incline will both increase every three minutes. You may hold onto a bar in front of you for balance as you perform the test. You will be asked to inform the nurse of any chest pain, leg pain, shortness of breath, or fatigue you may experience. To increase the effectiveness of the test it is important to exercise as long as you can. After you can no longer exercise you will quickly lie down and have the additional echocardiogram pictures taken.

An alternative method of stressing the heart can be used if the patient is unable to exercise. A medication called dobutamine can be infused through an IV at increasing doses. You will receive an IV if a dobutamine stress echo is performed. You will then be hooked up to the dobutamine. This medication raises the heart rate and the dose can be increased until a patient’s target heart rate is achieved. You may experience shortness of breath, headache, nausea, or palpitations as possible side effects.

You should wear comfortable, loose-fitting clothing. A shirt or blouse that buttons in the front is recommended. Women should wear a bra. You should wear comfortable walking shoes or sneakers. If you smoke, you should avoid doing so for four hours prior to the test. You should not eat or drink for four hours prior to the test. A small amount of liquid with medications is permissible but you should avoid coffee or tea. You should take your usual medications with two notable exceptions.

1. You should not take any beta blockers (for example, metoprolol, carvedilol, bisoprolol, atenolol, labetalol) for at least 12 hours prior to the test.
2. You should not take centrally acting calcium channel blockers (for example, diltiazem or verapamil) for at least 12 hours prior to the test.