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Dobutamine Stress Echocardiogram

A Dobutamine Stress Echo is a test that involves the infusion of a medication called dobutamine, simulating the effects of exercise on your heart.  Ultrasound images (Echo) will be taken before, during and after the dobutamine infusion.

Why is this test performed?

The test is used to evaluate your heart and valve function under exercise like conditions when you are unable to walk on a treadmill. The test is used to:

  • Determine your likelihood of having coronary artery disease
  • Evaluate the function of your heart and valves
  • Evaluate the effectiveness of your cardiac treatment plan
  • Determine how well your heart tolerates activity

Can I eat or drink on the day of the test?

  • Yes. However, DO NOT eat or drink anything except water for 4 hours before the test.
  • Avoid caffeinated products (cola, Mountain Dew®, chocolate products, coffee or tea) for 24 hours before the test, as caffeine will interfere with the results of the test. Also avoid decaffeinated or caffeine-free products, which contain trace amounts of caffeine.
  • DO NOT SMOKE ON THE DAY OF THE TEST, as nicotine will interfere with the results of your test.

Should I take my medications before the test?

Since many over-the-counter medications contain caffeine (such as diet pills, No Doz, Excedrin and Anacin), DO NOT take any over-the-counter medication that contains caffeine for 24 hours before the test. Ask your physician, pharmacist or nurse if you have questions about other medications that may contain caffeine.

DO NOT take these heart medications for 24 hours before the test, unless your physician tells you otherwise, or if it is needed to treat chest discomfort:

  • Coreg, Toprol, Lopressor, Metoprolol, Atenolol, Tenormin, Inderal, Propranolol, Diltiazem, Cartia, Verapamil, Diltia XT, Cardizem, Dilacor, Calan
  • Nitroglycerin (e.g., Minitran®, Nitropatches®, Nitrostat®)
  • Your physician may also ask you to stop taking other heart medications on the day of your test.
  • Bring an updated list of your medications with you the day of the test.
  • If you have any questions about your medications, ask your physician.

NOTE: Do not discontinue any medication without first talking with your physician.

Guidelines For People With Diabetes

  • If you take insulin to control your blood sugar, ask your physician what amount of your medication you should take the day of the test. Often, your physician will tell you to take only half of your usual morning dose and to eat a light meal four hours before the test.
  • If you take pills to control your blood sugar, do not take your medication until after the test is complete.
  • Do not take your diabetes medication and skip a meal before the test.
  • If you own a glucose monitor, bring it with you to check your blood sugar levels before and after your test. If you think your blood sugar is low, tell the lab personnel immediately. Plan to eat and take your diabetes medication following your test.

What should I wear on the day of the test?

You may wear anything you like. Before the test, you will change into a hospital gown. Please do not bring valuables with you the day of the test. You will be given a locker to store your belongings during the test.

What happens during the test?

  • Your test will take place at the EvergreenHealth Cardiovascular Imaging Center and the test will be supervised by a physician and a registered nurse with a cardiac sonographer obtaining the ultrasound images.
  • The test will be explained in detail and informed consent will be obtained.
  • Your chest will be prepared with alcohol (shaving may be required) and 10 electrodes will be placed.  The electrodes are attached to an EKG monitor that charts your heart’s electrical activity during the test.
  • An intravenous line (IV) will be inserted into a vein in your arm, so the dobutamine medication can be delivered directly into your bloodstream.
  • Before the ultrasound images are taken, we will perform a resting EKG, measure your resting heart rate and take your blood pressure.
  • The sonographer will then ask you to lie on your left side on an exam table so he or she can perform a resting echocardiogram (also called an “echo”). The sonographer will place a transducer on your chest to obtain the resting images.  It may be important to control your breathing and the sonographer will guide you through this.
  • Once preparations are complete and the resting images are taken, the lab personnel will notify the cardiologist that we are ready to begin.
  • Once the physician is present, the nurse will administer the dobutamine medication into the IV while the sonographer continues to obtain echo images periodically throughout the test..
  • The medication will cause your heart to react as if you were exercising: your heart rate will rise and you may feel it beating more strongly. It may cause a warm, flushed feeling.
  • At regular intervals, you will be asked how you are feeling. Please tell them if you feel chest, arm, or jaw pain or discomfort, shortness of breath, dizzy, lightheaded or any other unusual symptoms.
  • The staff will watch for any abnormal changes of your heart’s function by Echo and on the EKG monitor that suggest the test should be stopped.
  • The IV will be removed from your arm once the test is completed. Your heart rate should return to normal in about 5 to 10 minutes.

How long does the test take?

The appointment will take about 90 minutes. The actual infusion time is usually15 minutes or less.

How do I get the results of my test?

In most cases the cardiologist will discuss the results with you immediately upon completion of the test. 

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