STRESS ECHOCARDIOGRAM

Stress echocardiography is a test that uses ultrasound imaging to show how well your heart muscles are working to pump blood to your body. It is mainly used to detect a decrease in blood flow to the heart — coronary artery disease.

How the test is performed?

A resting echocardiogram will be done first. While you lie on your left side with your left arm up, 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 to produce an image.

You will then walk on a treadmill. Slowly (usually 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. Usually, you will need to walk for around 5 to 10 minutes. Your doctor will ask you to stop:

• When your heart is beating at the target rate

• When you are too tired to continue

• If you are having chest pain or a change in your blood pressure that worries your doctor

Your blood pressure and heart rhythm (ECG) will be monitored throughout the procedure.

More echocardiogram images will be taken when your heart rate reaches its peak. The images will show whether any parts of the heart muscle do not work at exercise. 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?

It is not recommended to eat, smoke, or drink beverages containing caffeine or alcohol for 2 hours before the test. Wear comfortable shoes (running or soft soled shoes) and loose (preferably two piece) clothing to allow you to exercise. As the electrodes are attached to your chest, you will be required to disrobe from the waist up. Gowns are supplied to allow you to cover up as much as possible. Please bring a list of your current medications.

How the Test Will Feel?

Electrodes (conductive patches) will be placed on your chest to record the heart’s activity. The preparation of the electrode sites on your chest may produce a mild burning or stinging sensation. The blood pressure cuff on your arm will be inflated every few minutes, producing a squeezing sensation that may feel tight. Baseline measurements of heart rate and blood pressure will be taken before exercise starts. You will start walking on a treadmill. The pace and incline of the treadmill will slowly be increased every few minutes. Ultrasound images will be taken before and after your time on the treadmill.

Sometimes, people experience some of the following during the test:

• Chest discomfort

• Dizziness

• Palpitations

• Shortness of breath

Why the Test is Performed?

Reasons why an exercise stress echocardiogram may be 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

• Have had a stress test with unclear results

• Have heart valve problems

The results of this stress test can help your doctor:

• 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