Exercise Stress Echocardiogram
An exercise stress echocardiogram incorporates a treadmill test along with imaging of the heart utilizing ultrasound (sound waves) to help determine if there are any structural abnormalities and/or areas of the heart muscle that do not receive enough blood supply due to coronary artery disease. Areas of your heart with possible damage from a previous heart attack may also be examined.
A full resting ultrasound will be obtained before the treadmill portion of the test, and images will also be obtained immediately after exercise. While you're on the treadmill, your blood pressure, heart rate and rhythm and ECG changes will be continually monitored. The treadmill starts slowly with a slight elevation, with speed and incline increasing every three minutes until your heart rate reaches a target rate based on your age. The treadmill portion usually lasts about five minutes, though the entire test takes approximately one hour.
The test is used to:
- Determine how well your heart tolerates activity
- Evaluate the function of your heart and heart valves
- Determine your likelihood of having coronary artery disease
- Evaluate the effectiveness of your cardiac treatment plan
How to prepare:
- You may have a light meal and fluids prior to the test.
- Take all of your regular medications the morning of the test unless otherwise instructed by your physician or procedure scheduler.
- Wear comfortable two-piece clothing and shoes that you can walk rapidly in. You will be asked to change into an exam cape to wear during the procedure.
- Please remove all neck jewelry prior to the test.
- If you use an inhaler for breathing, bring it to the test.
What to expect during the test:
- Before the test, a cardiac sonographer (a health professional trained to perform ultrasound examinations) will place small electrodes on your chest. The electrodes are attached to an electrocardiograph (ECG) monitor that charts your heart's electrical activity during the test.
- Before you begin to exercise, the sonographer will perform a resting ECG, measure your resting heart rate and take your blood pressure.
- You will be asked to lie on your left side on an exam table so the sonographer can perform a resting echo. A transducer will be placed on several areas of your chest with a small amount of cool gel on the end. The gel helps transmit clearer pictures of the heart's movement. You will be able to hear the sounds of blood passing through your heart valves during the test.
- You will exercise on a treadmill for a minimum of five minutes, gradually increasing your rate of exercise so that your heart rate, blood pressure, breathing and perspiration increase. This information allows your physician to assess your heart's functioning and capabilities.
- At regular intervals, lab personnel will ask how you are feeling. If you feel chest, arm or jaw pain or discomfort or become short of breath, dizzy or lightheaded, experience irregular heartbeats or have any other unusual symptoms, tell the stress lab personnel immediately.
- The lab personnel will watch for changes on the ECG monitor that suggest the test should be stopped.
- When you cannot exercise any longer, you will get off the treadmill, quickly return to the exam table and lie on your left side so the sonographer can perform another echocardiogram. It is normal to feel a little unsteady when getting off the treadmill and onto the exam table for the echo, as you stop exercising suddenly.
- Your heart rate, blood pressure and ECG will continue to be monitored after exercising until the levels return to normal.
The appointment takes about 60 minutes. The average exercise time is usually between five and 12 minutes.
What to expect after the test:
After the cardiologist reviews your test, the results will go into your electronic medical record. Your physician will have access to the results and will discuss them with you. If you have any questions about the echocardiogram, ask your doctor. You should expect to receive the results of your test within seven to 10 days.