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Stress Echocardiogram

A stress echo is a test that combines an ultrasound study of the heart with a treadmill stress test. A stress echo looks at how the heart functions at rest and after vigorous exercise.  Stress echo is especially useful in evaluating for coronary heart disease (heart artery blockages).

Why is this test performed?

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 exercise

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

Yes. However, DO NOT eat or drink anything except water for 1-2 hours before the test.

Avoid caffeinated products (cola, Mountain Dew, chocolate products, coffee or tea) for 24 hours before the test, as caffeine may 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 may interfere with the results of your test.

Should I take my medications the day of the test?

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

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 the following heart medications on the day of your test unless your physician tells you otherwise or if it is needed to treat chest discomfort the day of the test:

  • Beta blockers [for example: atenolol (Tenormin), carvedilol (Coreg), Metoprolol (Lopressor, Toprol), Propranolol (Inderal)]
  • Isosorbide dinitrate (for example: Dilatrate, Isordil, Sorbitrate)
  • Isosorbide mononitrate (for example: Ismo, Imdur, Monoket)
  • Nitroglycerin (for example: Minitran, Nitropatches, Nitrostat)
  • Your physician may also ask you to stop taking other heart medications on the day of your test. If you have any questions about your medications, ask your physician.
  • If you use an inhaler for your breathing, please bring it to the test.

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 4 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?

Please wear or bring comfortable clothes and shoes suitable for walking.

What happens during the test?

  • Your test will take place in the EvergreenHealth Cardiovascular Imaging Center and will be supervised by a registered nurse or an exercise physiologist. A cardiac sonographer will perform the ultrasound exam of your heart.
  • 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 a Stress EKG monitor that charts your heart's electrical activity during the test.
  • 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 (a small probe which we use to visualize your heart) 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 ask you to start exercising and will gradually increase the intensity of exercise. You will be asked to continue exercising until you are at your maximum level of capacity.
  • 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. Breath control is key and the sonographer will guide you through this.

How will I feel during the test?

You will be encouraged to exercise until you are exhausted. It is normal for your heart rate, blood pressure, breathing rate and perspiration to increase.

As you stop exercising suddenly, it is normal to feel a little unsteady when getting off the treadmill and onto the exam table for the echocardiogram; the staff will assist you as needed.

How long does the test take?

The total appointment time will take about 60 minutes. The actual exercise time is usually between 5 and 12 minutes, depending on age and fitness level.

How do I get the results of my test?

After a cardiologist has interpreted your test, the results will be sent to your primary care physician and or you will be called directly with results.  If your stress echo is being performed for FAA clearance, please let the staff know at the time of the test.

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