A stress echocardiogram is a non-invasive test that combines two procedures — an echocardiogram, immediately followed by an exercise stress test, and then another echocardiogram. An echocardiogram uses high-frequency sound waves to look at the structure and function of the heart. By repeating the echocardiogram after the exertion involved in a stress test, a picture of how the heart responds to exercise is provided.
Why is it performed?
A stress echocardiogram is usually done to look for evidence of previous heart muscle damage and to find out if there are areas of the heart muscle which have impaired blood supply.
What is experienced?
Patients should be dressed for exercise, such as in slacks, a shirt, and sneakers. Electrodes for the EKG will be attached to the chest. Before the echocardiogram, a cool, colorless gel is applied to the chest and to the tip of the wand held by the cardiac sonographer. As the wand is gently moves across the chest, soft, thumping sounds may be heard from the movement of blood through the blood vessels.
Next, the patient exercises on the treadmill or stationary bike until either the heart rate reaches just below maximal levels, the EKG shows abnormalities in heart rhythm, or the blood pressure goes too high or too low — or the patient develops symptoms and asks to stop. Then the echocardiogram is repeated.
The sonographer places three electrodes on the chest, attached by wires to an electrocardiograph monitor to generate an electrocardiogram (ECG). The patient lies on his left side while the sonographer applies the sound-wave transducer to the chest. The sonographer moves the wand and records a permanent record of the images from a monitor.
For the exercise stress test, a technician attaches the EKG electrodes to the chest and a blood pressure cuff around the upper arm. A cardiologist monitors the patient while the patient exercises and determines the length of the test, depending on the patient’s response. This could be as short as a minute or two or could be as long as ten minutes. When the doctor decides that the exercise stress has been sufficient, the exercise portion ends and the electrocardiogram is repeated. Depending on the extent of the procedure, it may take anywhere from 45 to 60 minutes.