Stress echocardiogram

What is a stress echocardiogram?

An exercise echocardiogram is a type of ultrasound scan. It helps detect how well your heart is working while you are participating in a physical activity such as running. We will also monitor your blood pressure, heart rhythm, and oxygen levels alongside your heart’s activity. It allows us to monitor how your heart is performing under strain.

We usually perform this test to learn:

• How well your heart pumps blood through your vessels and whether your heart is receiving an adequate blood supply
• Whether exercise worsens your symptoms or investigates whether your symptoms stop you from exercising safely, especially if you have symptoms like chest pain, shortness of breath, dizziness, or tiredness when active.

It can help find problems such as blocked heart arteries, heart muscle damage from a past heart attack, heart valve issues, heart failure, or other heart conditions. By comparing your heart images when at rest and during stress, the test determines if your heart is receiving enough blood and functioning properly when it’s working harder.

Preparation

Generally, little preparation is needed for a stress echocardiogram as it is a minimally invasive scan.

We recommend wearing light, easy-to-wear exercise clothing and shoes (preferably trainers) to feel as comfortable as possible while participating in the activity. You should also wear clothing you can easily remove, as you will need to have electrodes fitted to your chest before starting the test, and the ultrasound wand will have to be applied to bare skin.

You must avoid caffeine for 6 to 10 hours before the test because it can speed up your heart rate and affect your results. You must not eat anything or smoke for two hours before the test. Certain medications can also interfere with the test. We will discuss with you what you are currently taking and whether we need to adjust your intake to perform the test.

Procedure

Before we begin the procedure, we will ask you to undress from the waist up. We will then stick small electrodes to your chest, attached by small wires to a machine that will monitor your heart’s rhythm.

While you’re resting, we will perform an initial electrocardiogram and echocardiogram. We will ask you to lie down on your left side and move an ultrasound wand (transducer) across your chest to collect images of your heart. This will give us a picture of your heart in a resting state against which to compare your results.

We will then ask you to start exercising on either a treadmill or an exercise bike, starting slowly and increasing with intensity as you go on. You will continue to exercise until you reproduce your symptoms or reach your target heart rate. The total exercise time will range from 10 to 20 minutes.

As you exercise, please notify us if you are struggling to do the exercise or are experiencing unusual symptoms, particularly if you notice chest pain, discomfort in your chest, arm, or jaw, shortness of breath, dizziness, or light-headedness. 

Once you have finished the exercise, you will return to the exam table for a repeat echocardiogram, either lying down or while on the exercise equipment.

Results and aftercare

Once the test has been completed, you will have a moment to recover from the exercise and compose yourself before returning to your daily activities. We still recommend you take it easy for the rest of the day to avoid triggering your symptoms.

You may feel tired for a few hours after the test, especially if you don’t exercise regularly, but this is normal. If you feel tired for more than a day, contact us immediately for a follow-up.

We will analyse your results and determine what may be causing your symptoms. We will then schedule an appointment to discuss the results and your next steps. If your symptoms worsen or if you have developed new symptoms after the test, please notify us immediately.

Frequently asked questions

Is it safe?

Generally, a stress echocardiogram is safe. However, it can carry some risks such as abnormal heart rhythms, chest pain, or, very rarely, a heart attack. Most side effects, such as dizziness or nausea, are temporary and typically resolve themselves quickly. Our team will closely monitor you throughout the test to quickly address any issues that may arise. Overall, the benefits of the test in diagnosing any heart conditions usually outweigh these minimal risks.

How long will it take?

The test typically lasts 45 minutes to an hour, although the actual exercise portion is shorter.