Stress Echocardiography

Echocardiography is a test that assesses the function and structure of the heart, and stress echocardiography assesses how the heart works during exertion. “Stress” can be caused by exertion on the ergometer or with the help of the drug – dobutamine. Dobutamine stress echocardiography can be used if you are unable to exert physical exertion. In this case, you will receive dobutamine intravenously, which will accelerate the rhythm of your heart. It mimics the effect of physical exertion on the heart.
During examination, the probe rests on your chest and emits ultrasound waves through the skin and other tissues to the heart, where the waves bounce off the heart structures. The probe registers the reflected waves and transmits them to a computer, which displays them as images of heart walls and valves.

INDICATIONS / WHY IS IT WORKING?
• To evaluate the function and structure of your heart.
• To further evaluate the extent of known cardiac valve disease.
• To determine the limits of safe physical exertion before you begin a rehabilitation program or recovery from a heart attack or heart surgery.
• To evaluate your heart condition before heart surgery.
HOW DOES IT WORK?

• You will remove all jewelry and other objects that may interfere with the test. You can use glasses.
• You will empty your bladder before the test begins.
• You will be given an intravenous line through which you will receive dobutamine and fluid, if needed.
• You will lie on your left side on a table or bed, though you will change position when the doctor asks you to.
• You will be connected to an electrocardiogram (ECG) monitor that records the electrical activity of your heart with the help of electrodes attached to your chest. Your vital signs (heart rate, blood pressure, respiration rate and blood oxygen level) will be monitored during the test. The ECG record will be compared to the images shown on the echocardiogram monitor.
• The room will be dark so that the images on the monitor can be clearly seen.
• The doctor will place a warm gel on your chest and then a probe on the gel. You will feel a slight pressure as the doctor sets up the probe to get the best picture of your heart.
• Dobutamine infusion will start at a dose determined by your body weight. The dose of dobutamine will increase every few minutes until you reach your target heart rate (determined by your doctor based on your age and physical fitness), or until the maximum dose of dobutamine is reached.
• At the beginning, as well as after any increase in the dose of dobutamine, your blood pressure, ECG record and echocardiographic images will be recorded.
• The doctor will move the probe around your chest to observe all parts and structures of the heart.
• When you reach your target heart rate or maximum dose of dobutamine, the infusion will be stopped. Your blood pressure, heart rate and ECG will continue to be monitored for the next 10 to 15 minutes, until they return to their initial resting state. The final echocardiographic images will then be collected.
• Report to your doctor if you have any chest pain, difficulty breathing, sweating or beating at any time during the test!
• After all echocardiographic images have been collected, the doctor will wipe the gel off your chest, remove the ECG electrodes and the intravenous line. Then you can get dressed.

POTENTIAL RISKS
• There may be chest pain, a significant jump in blood pressure, heart failure, dizziness, nausea, extreme fatigue.
• In very rare cases, a heart attack occurs during the test.
PREPARATION
• After the doctor explains the procedure to you, you will need to sign the consent form for the test. Read the form carefully and ask what you don’t understand.
• Tell your doctor if you are allergic to any medication or latex!
• Do not bring food or liquids 3-4 hours before the test. Do not smoke cigarettes or consume caffeinated beverages such as coffee, tea or juice on the day of the test.
• Tell your doctor about any medicines, supplements, vitamins, and herbs you use.
• Some medicines may be excluded before the test, such as beta-blockers.
• Report if you may be pregnant or have a pacemaker.

AFTER RECORDING
You can get back to your usual diet and activities.