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Cardiac Stress Test or Stress Echocardiography

Stress echocardiography is a test that uses ultrasound imaging to determine how the heart muscles respond to stress. It is mainly used to diagnose and evaluate coronary artery disease (coronary heart disease or CHD), a condition in which a fatty material called plaque (plak) builds up in the coronary arteries and reduces blood flow to your heart muscle. The test is performed to see whether your heart muscle is getting enough blood flow and, therefore, enough oxygen when it is working hard (under stress).

The results of this stress test can help your doctor:

  • Determine how well a heart treatment is working and change your treatment, if necessary
  • Determine how well your heart is pumping
  • Diagnose coronary artery disease
  • See whether your heart is too large

Your doctor may request this test if you:

  • Have new symptoms of angina or chest pain
  • Have angina that is becoming worse
  • Have recently had a heart attack
  • Are at high risk for heart disease (before having surgery or when beginning an exercise program)
  • Have heart valve problems

 

Procedure details

A stress echocardiogram includes the following steps:

  • A resting echocardiogram will be done first.
  • You will exercise or be given medicine until you reach the target heart rate. This helps reveal how your heart works when you are active.
  • Your blood pressure and heart rhythm (ECG) will be monitored throughout the procedure.
  • Ultrasound images will be recorded during the procedure.
  • Another echocardiogram is taken immediately after your target heart rate has been reached.
  • The ultrasound images will reveal any parts of the heart that may not be receiving enough blood or oxygen because of blocked arteries.

This test differs from an exercise stress test, which does not use ultrasound images.

If you are not able to exercise, you will receive a medication such as dobutamine through a vein (intravenous line). This type of medicine will make your heart beat faster and harder, similar to when you exercise. This is called a pharmacological stress test.

If the results of this test are abnormal, you may need:

  • Angioplasty and stent placement
  • Changes in your heart medicines
  • Coronary angiography
  • Heart bypass surgery

 

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