Stress Echo

Stress Echo with Exercise

A stress echocardiogram actually combines two common tests:  the cardiovascular exercise stress test and the echocardiogram. A stress echo (exercise) involves walking on a treadmill while your heart is continuously monitored with an electrocardiogram (EKG) and a nurse to assess your heart function at both rest and during exercise. Also an echocardiogram will be obtained both before and after exercising.

What will happen during the test?

The entire cardiovascular stress test will take approximately 1 1/2 hours. You will be asked to remove your shirt or blouse and given a towel or gown to keep you comfortable and maintain privacy. After lying on an examination table, the technologist will apply a colorless gel to your chest. A transducer will be moved across your chest to record different views of your heart.

During the stress echocardiogram, first, resting images of the heart are obtained. Second, an exercise tolerance test (ETT) or "stress" test is performed. The stress test measures some aspects of your heart's performance during physical activity. Electrodes will be placed on the chest in the same manner as an EKG. Your blood pressure, heart rate, and EKG will be recorded at rest, usually while you are lying on your back, and again while standing.

You will then be asked to perform a "graded" exercise test on a motor-driven treadmill. The exercise protocol that you will follow will be determined by the nurse supervising your test, but will begin at a relatively easy level and become progressively more difficult with each subsequent stage. Your blood pressure, heart rate, and EKG will be recorded at frequent intervals during exercise and after exercise. The nurse may stop the test at any time for medical reasons. You may ask to stop the test at any time because of significant fatigue or discomfort. However, we encourage you to exercise as long as possible so that we may assess your heart under maximum stress.

When maximum stress is reached the treadmill will be stopped fairly quickly. Once the treadmill is stopped you will be asked to immediately sit and then roll onto your left hip with your left arm under your head. The technologist will quickly use the transducer to capture the stress portion echocardiogram images for one minute. You may be asked to exhale and hold it for as long as you can during this part of the test. The technologist will record and store both the rest and stress echocardiogram images.

Stress Echo without Exercise

A stress echocardiogram, non-exercise, combines a stress test and the echocardiogram but is used for patients who are unable to exercise. In lieu of exercise on a treadmill, the medication Dobutamine is administered, which simulates the treadmill exercise test by raising the heart rate. During the test your heart is continuously monitored with an electrocardiogram (EKG) and a doctor can assess your heart function both at rest and while under stress.

What will happen during the test?

The entire cardiovascular stress test will take approximately 1 1/2 hours. You will be asked to remove your shirt or blouse and given a towel or gown to keep you comfortable and maintain privacy. After lying on an examination table, the technologist will apply a colorless gel to your chest. A transducer will be moved across your chest to record different views of your heart.

Electrodes will be placed on your chest to monitor your EKG throughout the test, and a blood pressure cuff will be placed around your arm to monitor your blood pressure periodically during the test. First, resting images of the heart will be obtained.    

Second, a small intravenous (IV) line will be placed in a superficial vein in your arm or hand. A special pump will be used to infuse Dobutamine into your bloodstream for approximately 12 to 15 minutes. The technologist will be capturing images of your heart throughout this infusion. You may be asked to exhale and hold it for as long as you can during this part of the test. The technologist will record and store both rest and stress images. A nurse will be monitoring blood pressure, heart rate and EKG during entire procedure.

After completion of the infusion, we will continue to monitor you for a few minutes.

Frequently Asked Questions

How should I prepare for the Stress Echo?

Wear loose, comfortable clothing and shoes suitable for exercise. Please eat only a light meal before your test, keeping in mind you will be exercising.

*If you are taking any of the following medications, they must be held for 2 days prior to the test unless otherwise specified by your physician:

  • Acebutolol
  • Atenolol
  • Betapace
  • Betaxolol
  • Bisoprolol
  • Blocadren
  • Brevibloc
  • Bystolic
  • Cardizem
  • Coreg (Carvedilol)
  • Corgard
  • Diltiazem
  • Dutoprol
  • Esmolol
  • Inderal
  • Innopran
  • Kerlone
  • Labetalol
  • Levatol
  • Metroprolol
  • Nadalol
  • Pindolol
  • Penbutolol
  • Propanolol
  • Sectral
  • Sotalol
  • Tenormin
  • Tenoretic
  • Timolol
  • Toprol
  • Trandate
  • Verapamil
  • Visken
  • Ziac
  • Zebeta

*Failure to hold these medications will result in rescheduling of your procedure. If you have any questions regarding your medications, please call for clarification.

What should I bring with me to the Stress Echocardiogram?

  • Inhalers, if you use them
  • Medications in original bottles
  • Insurance card
  • Referral for stress echo test, if required by your insurance company
  • Previous echocardiogram report if from outside facility

Once your appointment has been scheduled, it is very important that you keep that appointment. If you are unable to keep the appointment, please give the office at least 24 hours notice that you are canceling your test. Our busy schedule requires tight scheduling restrictions, and it would be appreciated if you would notify our office if you will be late for your appointment. Thank you for your cooperation.

Who will give me the test results? 

If your test was ordered by a provider who is not an Upstate Cardiology physician, you will receive your test results from the provider who ordered your test. If there is a critical finding on your test, Upstate Cardiology will notify you within 24 hours of your test and will also make sure the ordering provider is aware. Otherwise, if you have not heard from your provider and it has been two weeks since your test, we recommend that you call the provider who ordered the test to seek results.

If an Upstate Cardiology physician ordered your test, you will receive and review your test results with your cardiologist at a follow up visit for that purpose, unless your cardiologist indicated that he or she will call you with your results. If your diagnostic test reveals a critical finding, we will call you within 24 hours of your test to expedite your care and follow-up. If you've not heard from or seen us within 2 weeks of your test, please call 864-235-7665.