Cardiac stress testing

Exercise stress echo

An exercise stress echo, also called a stress echocardiogram or cardiac stress test, combines an ultrasound of your heart with a stress test performed on a treadmill while being closely monitored.

Why do I need an exercise stress echo?
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In a healthy heart, all areas of the heart muscle work harder upon exertion. Abnormal movement could indicate a blockage in a coronary artery that supplies blood to that area. While it is possible to detect abnormal movement of the heart and blood supply at rest, the best indicator of previous damage or a current blockage is to exercise the heart muscle and immediately monitor activity to catch abnormalities. An exercise stress echo can be used to: 

  • Determine likelihood of having coronary artery disease 
  • Evaluate how well your heart tolerates activity 
  • Monitor and evaluate the function of your heart and valves 
  • Assess the effectiveness of your cardiac treatment plan
How should I prepare for an exercise stress echo?
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  • Do not eat or drink within 4 hours of your test. You may have sips of water leading up to the test. 
  • Avoid products that contain caffeine for 24 hours before the test 
  • If you are diabetic, call the testing center for special instructions 
  • Take your medications at your usual times. You may use inhalers as normally prescribed 
  • Do not take beta blockers for 24 hours before the test unless a nurse or doctor has told you to continue taking as prescribed
    • If you are told to take, be sure to take with water
  • Do not do any difficult activity before or after your test. Do not jog or workout on the day of your test
What should I bring to my appointment?
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  • Insurance cards 
  • A current list of medications you are taking. Please include how much you take (dose in mg) and how often you take 
  • Wear comfortable clothes and shoes you are able to exercise in
What should I expect during my test?
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  • You will be asked to come back to the testing area; only the patient will be allowed into the testing area 
  • You will be asked to sign a consent form. This form provides information regarding the benefits and risks of the stress test. Please do not hesitate to ask questions if something is not clear 
  • Your skin will be prepped for the electrodes that go on your chest. The electrodes will connect to a monitor measuring your heart rate and rhythm. It will be closely watched throughout the test. 
  • The echo tech will record the baseline heart activity at rest. You will be asked to lie on your left side and the images will be obtained through a transducer placed on your chest 
  • The stress portion of your test will be completed with exercise or medication. If your doctor ordered an exercise stress test, you will use a treadmill 
  • The treadmill will start out slowly and gradually increase in speed and/or resistance (incline) 
  • While you are on the treadmill, your heart rate and blood pressure will gradually rise. This is normal and both will be monitored along with your echocardiogram 
  • You will be encouraged to exercise as long as you can. The echo tech will ask you how you feel at each interval. If you experience any symptoms, such as chest pain/arm discomfort, unusual shortness of breath or lightheadedness, immediately inform the tech performing the test 
  • Immediately following peak exercise, you will quickly move to the examination table, where the echo tech will obtain a second echocardiogram of your heart while your heart rate is still elevated

Dobutamine stress echocardiogram

If you need a stress echocardiogram but you are unable to exercise, your provider will order a Dobutamine stress echocardiogram. Dobutamine is a medication which causes your heart to beat faster and harder. The dobutamine is infused through an intravenous (IV) port over 15 minutes and is stopped when a target heart rate is reached. During and after the infusion of the medication, the echo tech will take images of your heart.

How will I feel during the test?
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You may feel your heart beat faster. If you experience symptoms during the test, please be sure to inform the echo tech performing the test.

How long does the test take?
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The appointment will take approximately 60-75 minutes. The actual exercise time is usually between seven and 12 minutes.

How will I get my results?
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A Cardiologist will review your results and enter them into your electronic medical record. Your physician will then be notified of the results. You may be asked to schedule a follow up visit, or your physician may choose to call you with the results. The testing staff are unable to provide you with your results.

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