Stress Echocardiogram

Stress echocardiography is a test that uses ultrasound imaging to show how well your heart muscle is working to pump blood to your body. It is most often used to detect a decrease in blood flow to the heart from narrowing in the coronary arteries.

How the Test is Performed :

• This test is done at a medical center or health care provider’s office.
• A resting echocardiogram will be done first. While you lie on your left side with your left arm out, a small device called a transducer is held against your chest. A special gel is used to help the ultrasound waves get to your heart.
• Most people will walk on a treadmill. Slowly (about every 3 minutes), you will be asked to walk faster and on an incline. It is like being asked to walk fast or jog up a hill.
• In most cases, you will need to walk for around 5 to 15 minutes, depending on your level of fitness and your age. Your provider will ask you to stop:
  • When you are too tired to continue
  • If you are having chest pain or a change in your blood pressure that worries the provider administering the test

• If you are not able to exercise, you will get a drug, such as dobutamine or regadenoson with atropine, through a vein (intravenous line). This medicine will make your heartbeat slightly faster and make vessels dilate. The vessels that are narrow, will have less dilation.
• Your blood pressure and heart rhythm (ECG) will be monitored throughout the procedure.
• Final images will be obtained after you stop exercising or after complete administration of medication. The images will show whether any parts of the heart muscle do not work as well when your heart rate increases. This is a sign that part of the heart may not be getting enough blood or oxygen because of narrowed or blocked arteries.

How to Prepare for the Test :

• Ask your provider if you should take any of your routine medicines on the day of the test. Some medicines may interfere with test results. Never stop taking any medicine without first talking to your doctor.
• It is important to tell your doctor if you have taken any of the following medicines within the past 24 hours (1 day):
  • Sildenafil citrate (Viagra)
  • Tadalafil (Cialis)
  • Vardenafil (Levitra)
• DO NOT eat or drink for at least 3 hours before the test.
  Wear loose, comfortable clothing. You will be asked to sign a consent form before the test.

Why the Test is Performed :

• The test is performed to see whether your heart muscle is getting enough blood flow and oxygen when it is working hard (under stress).
• Your doctor may order this test if you:
  • Have new symptoms of angina or chest pain
  • Have angina that is getting worse
  • Have recently had a heart attack
  • Are going to have surgery or begin an exercise program, if you are at high risk for heart disease
  • Have heart valve problems
• The results of this stress test can help your provider:
  • Determine how well a heart treatment is working and change your treatment, if needed
  • Determine how well your heart is pumping
  • Diagnose coronary artery disease

Normal Results :

• A normal test will most often mean that you were able to exercise as long as or longer than most people of your age and gender. You also did not have symptoms or concerning changes in blood pressure and your ECG. Your heart pictures show that all parts of your heart respond to increased stress by pumping harder.
• A normal result means that blood flow through the coronary arteries is probably normal.
• The meaning of your test results depends on the reason for the test, your age, and your history of heart and other medical problems.

Abnormal Results  :

• Abnormal results may be due to :
  • Reduced blood flow to a part of the heart. The most likely cause is a narrowing or blockage of the arteries that supply your heart muscle.
  • Scarring of the heart muscle due to a past heart attack.