Stress Echocardiogram: About This Test

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What is it?

Man getting an echocardiogram

An echocardiogram (also called an echo) uses sound waves to make an image of your heart. A device called a transducer is moved across your chest. It looks like a microphone. The transducer sends sound waves that echo off your heart and back to the transducer. These echoes are turned into moving pictures of your heart that can be seen on a video screen.

In a stress echocardiogram, an echo is done while your heart is at rest and after your heart is made to work hard (stressed). You exercise to make your heart work hard.

Sometimes, instead of exercise, a medicine is used that makes your heart respond like you have been exercising.

Why is this test done?

A stress echocardiogram is usually done to find out if you might have reduced blood flow to your heart. This is known as coronary artery disease.

Reduced blood flow is easier to see when your heart is put under some form of stress.

How can you prepare for the test?

  • Do not smoke or eat a heavy meal before this test.
  • Wear flat, comfortable shoes (no bedroom slippers) and loose, lightweight shorts or sweatpants. Walking or running shoes are best.
  • Tell your doctor if:
    • You are taking any medicines.
    • You are taking medicine for an erection problem, such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra). You may need to take nitroglycerin during this test, which can cause a serious reaction if you have taken a medicine for an erection problem within the past 48 hours.
    • You have had bleeding problems, or if you take aspirin or some other blood thinner.
    • You have joint problems in your hips or legs that may make it hard for you to exercise.
    • You have a heart valve problem.

What happens during the test?

You will first have an echocardiogram before exercising. This is called the baseline. You then exercise for a specific amount of time and then have another echocardiogram.

  • You will take off all or most of your clothes and change into a gown.
  • You will lie on your back or on your left side on a bed or table.
  • You may receive medicine through a vein (intravenously, or IV). The IV can be used to give you a contrast material, which helps your doctor get good views of your heart.
  • Small pads or patches (electrodes) will be taped to your arms and legs to record your heart rate during the test.
  • A small amount of gel will be rubbed on the left side of your chest to help pick up the sound waves.
  • The transducer will be pressed firmly against your chest and moved slowly back and forth. It is usually moved to different areas on your chest to get specific views of your heart.
  • You will be asked to do several things, such as hold very still, breathe in and out very slowly, hold your breath, or lie on your left side.

This test usually takes 30 to 60 minutes.

When the echocardiogram is finished, you will exercise and then have another echocardiogram. If you are not able to exercise, you may be given medicine that stimulates your heart to beat harder and faster, as if you were exercising. You most likely will either walk on a treadmill or pedal a stationary bicycle. While you exercise:

  • Your heart rate and blood pressure are recorded.
  • You might be asked to use numbers to say how hard you are exercising. The higher the number, the harder you think you are exercising.
  • You will continue to exercise until you or your doctor feels you need to stop.
  • You will then lie on a bed or table, and another echocardiogram will be done.

An exercise stress echocardiogram takes about 30 to 60 minutes.

What else should you know about the test?

  • No electricity passes through your body during the test. There is no danger of getting an electrical shock.
  • During the tests, tell your doctor if:
    • You have chest pain.
    • You are very short of breath.
    • You are light-headed.
    • You have other symptoms.

What happens after the test?

  • You will be able to sit or lie down and rest.
  • Your heart rate and blood pressure will be checked for about 5 to 10 minutes.
  • You can go back to your usual activities right away.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).
  • You have been diagnosed with angina, and you have chest pain that does not go away with rest or is not getting better within 5 minutes after you take a dose of nitroglycerin.
  • You have symptoms of a heart attack, such as:
    • Chest pain or pressure.
    • Sweating.
    • Shortness of breath.
    • Nausea or vomiting.
    • Pain that spreads from the chest to the neck, jaw, or one or both shoulders or arms.
    • Dizziness or light-headedness.
    • A fast or uneven pulse.
    After calling 911, chew 1 adult-strength aspirin. Wait for an ambulance. Do not try to drive yourself.

Call your doctor or nurse call line now or seek immediate medical care if:

  • You are having chest pain more often than usual, even if it goes away when you rest or take nitroglycerin.
  • You feel dizzy or light-headed, or you feel like you may faint.

Watch closely for changes in your health, and be sure to contact your doctor or nurse call line if you have any problems.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to keep a list of the medicines you take. Ask your doctor when you can expect to have your test results.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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