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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.
Echocardiography stress test; Stress test - echocardiography
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 (or pedal on an exercise bicycle). About every 3 minutes, you will be asked to walk (or pedal) faster and on an incline (or with more resistance if you are on a bike). It is like being asked to walk fast or jog up a hill.
Most of the time you will need to walk or pedal for 5 to 10 minutes or more. Your doctor will ask you to stop:
If you are not able to exercise, you will get a medicine such as dobutamine through a vein (intravenous line). This drug will make your heart beat faster and harder, similar to when you exercise.
Your blood pressure and heart rhythm (ECG) will be monitored throughout the procedure.
More echocardiogram images will be taken while your heart rate is increasing, or when it reaches its peak. The images will show whether any parts of the heart muscle do not work as well as 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.
Ask your health care provider if you should take any of your regular 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 medications within the past 24 hours (1 day):
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.
Electrodes (conductive patches) will be placed on your chest, arms, and legs to record the heart's activity.
The blood pressure cuff on your arm will be inflated every few minutes, producing a squeezing sensation that may feel tight.
Rarely, people feel chest discomfort, extra or skipped heartbeats, dizziness, or shortness of breath during the test.
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:
The results of this stress test can help your doctor:
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 may be due to:
After the test you may need:
The risks are very low. Health care professionals will monitor you during the entire procedure.
Rare complications include:
Boden WE. Angina pectoris and stable ischemic heart disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 71.
Connolly HM, Oh JK. Echocardiography. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 15.
Fraker TD Jr., Fihn SD, Gibbons RJ, et al. 2007 chronic angina focused update of the ACC/AHA 2002 Guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Writing Group to develop the focused update of the 2002 Guidelines for the management of patients with chronic stable angina. Circulation. 2007;116:2762-2772.
Mahajan N, Polavaram L, Vankayala H, et al. Diagnostic accuracy of myocardial perfusion imaging and stress echocardiography for the diagnosis of left main and triple vessel coronary artery disease: a comparative meta-analysis. Heart. 2010;96(12):956-966.