A stress ECHO is a test given while you walk on a treadmill or pedal a stationary bike to monitor your heart during exercise.
Ultrasound is used to create images of your heart and provides information about how well your heart handles different levels of activity. As your body works harder during the test, your oxygen needs increase, requiring the heart to pump more blood.
UPMC cardiologists are experts at using the latest in stress echocardiography technology to diagnose and monitor a range of heart conditions.
What Is A Stress ECHO Test?
A stress echocardiogram is a widely used test that creates moving images of your heart while you are increasing your heart rate with exercise or by taking medication that increases your heart rate. Your cardiologist uses this information to diagnose your heart condition and determine the best course of treatment.
How does a stress ECHO test work?
A stress echocardiogram test uses ultrasound technology to create a multidimensional image of your heart's structure, rhythm, and blood flow. The test will assess your heart's size, shape, performance, valves, and chambers.
During a stress ECHO test, a transducer (like a microphone) is placed on your chest at certain locations and angles. The transducer sends out ultrasonic sound waves that move through your skin and other body tissues to the heart tissues, bouncing or "echoing" off of the heart structures.
As you walk on a treadmill or pedal a bike, these sound waves are sent to a computer that creates moving images of the heart walls and valves.
What are the different types of stress echocardiograms?
There are two primary types of stress echocardiograms:
- Exercise stress ECHO is performed on a treadmill or bicycle and measures how your heart responds to an increase in activity (stress).
- Pharmacological stress ECHO uses medication such as dobutamine, dipyridamole, or adenosine to increase your heart rate. The medicine is given through an IV into your arm. Your doctor may recommend this type of stress ECHO if you cannot exercise.
What does a stress echocardiogram show?
A stress echocardiogram can show if your heart, heart valves, and blood pumping rate are normal or if you have heart disease or another heart condition.
Healthy coronary arteries dilate or open during exercise to supply more blood to the heart muscle. When the arteries are narrowed due to a blockage, they supply a reduced flow of blood. This reduced flow causes the muscle to "starve" during exercise, producing symptoms such as chest pain or shortness of breath. This reduced flow will show up on the echocardiogram.
Specifically, a stress echocardiogram can help your doctor:
- Determine how well a heart treatment is working and, if necessary, change your treatment.
- Determine how well your heart is pumping.
- Diagnose coronary artery disease.
- See whether your heart is too large.
Why Would I Need A Stress Echocardiogram Test?
Your doctor may recommend a stress ECHO test if you have:
- Borderline hypertension.
- Exercise-induced serious irregular heartbeats.
- Heart valve problems.
- New symptoms of angina or chest pain or angina that is becoming worse.
- Recently had a heart attack.
- Significant risk factors for coronary artery disease.
- Symptoms or signs of coronary artery disease.
- Unexplained fatigue and shortness of breath.
What Are the Risks and Complications Of An Echocardiogram?
Echocardiograms are generally safe, but a stress ECHO may carry some risks.
- You may experience chest pain, dizziness, or shortness of breath while exercising.
- An abnormal heart rhythm can occur from exercise or dobutamine, which usually goes away when the test is over.
- In rare cases, a heart attack can occur (1 in 1,000 cases).
What Should I Expect From A Stress Echocardiogram?
How to prepare for a stress echocardiogram
Your cardiologist will explain the procedure to you and answer any questions you might have.
- Tell your doctor if you are sensitive or allergic to any medications, iodine, latex, tape, or anesthetic agents (local and general).
- Tell your doctor about all medications (prescription and over-the-counter) and herbal or other supplements you are taking.
- Do not eat or drink for four hours before your test to avoid feeling sick to your stomach while you exercise.
- Wear flat, comfortable shoes and loose, lightweight clothing.
- Ask your doctor if it is safe for you to take your regular medications prior to your test.
- You may not be able to drive for 24 hours after the stress echo test. Arrange for someone to drive you home.
How long does a stress ECHO take?
Your stress echocardiogram test will take about 30-60 minutes.
What to expect during your stress echocardiogram
Before the test, you will remove any clothing above your waist and put on a hospital gown.
You may receive an IV that injects contrast material in order to get a better picture of your heart. The contrast material does not contain iodine and will not injure the kidneys.
During your stress ECHO:
- A technologist will place sticky patches (called electrodes) on your chest. These will record your heart’s rate, rhythm, and electrical activity in an electrocardiogram (EKG).
- The technologist will take a resting echocardiogram before your activity or medicine-induced stress.
- You will walk on a treadmill or pedal a stationary bike to make your heart work harder.
- If you cannot exercise, you will get an infusion of medicine called dobutamine through an IV to make your heart work harder.
- Throughout the activity or stress portion of the test, the technologist monitors your heart’s rate, rhythm, and electrical activity through an EKG.
- After activity or stress, the technologist will take another TTE.
- The test usually takes 30-60 minutes.
Recovery after a stress echocardiogram
After the procedure has been completed, the technologist will wipe the gel from your chest and remove the EKG electrode pads.
You may resume your usual diet and activities unless your doctor advises you differently. Generally, there is no special type of care following a stress echocardiogram. However, your doctor may give you additional or alternate instructions after the procedure, depending on your diagnosis or physical condition.
What do echocardiogram results mean?
Normal results mean that:
- Heart chambers and valves are working properly.
- The amount of blood your heart pumps is normal.
- There is no extra fluid around your heart.
- There are no tumors or blood clots present.
Abnormal results can vary depending on your specific condition and may include:
- Your heart chambers or valves are not working properly.
- The amount of blood your heart pumps is not enough to support your body’s needs.
- There is extra fluid around your heart.
- A tumor or blood clot is present.
By UPMC Editorial Staff. Last reviewed on 2024-10-01.
