Dobutamine Stress Echocardiogram

What is a dobutamine stress echocardiogram?

An echocardiogram or ‘echo’ is a scan that uses ultrasound (sound waves) to produce pictures of the heart.  A stress echocardiogram is a test done to assess how well the heart works under stress produced by a medicine called dobutamine.

Why is it being done?

A Dobutamine Stress Echocardiogram allows your doctor to understand how the heart copes when it is made to work harder. It is useful to diagnose whether there is a lack of blood supply to the heart muscle. It can also give your doctor information about the severity of heart valve problems.

How do I prepare for the Dobutamine Stress Echocardiogram?

You must not take beta-blocker or calcium-channel blocker tablets for 48 hours before the test. Beta-blocker tablets include Atenolol, Bisoprolol and Carvedilol, although there are others. Calcium-channel blockers include Diltiazem and Verapamil, although there are others. These tablets can prevent the heart from working to its appropriate level. If you continue with these drugs, the Dobutamine Stress Echocardiogram may need to be postponed.  If you have any doubts, please contact us.

You should continue other medications as usual.

Do not eat any food 6 hours and do not drink any liquids 3 hour before the test.

What does it involve?

You will be asked to empty your bladder before the test.

This test will take place in a clinical room. Two people will be present when you have the test – typically a doctor and a nurse.

You will be asked to undress to the waist and put on a gown that should be left open to the front.

Stickers will be placed on your chest and connected to the machine.  These will be used to monitor your heart rate and record the electrocardiogram (ECG).  Your blood pressure will be checked regularly throughout the test.

An intravenous (IV) line will be inserted into a vein in your arm, so the medication (dobutamine and atropine) and contrast agent can be delivered directly into your bloodstream.

You will lie on a couch on your left hand side.

The nurse will administer the medication and contrast into the IV line while the doctor will obtain echo images of the heart.

The medication will make your heart beat faster and more strongly as if you are exercising. It may cause a warm or flushing feeling, and in some cases, a mild headache.

The doctor and the nurse will ask how you are feeling. Please tell them if you have  any discomfort (pain in chest, arm, or jaw, shortness of breath, dizziness) or any other symptoms.

The IV line will be removed once the test is completed. Your heart rate should return to normal within 5 to 10 minutes.

Overall the Dobutamine Stress Echocardiogram takes upto 60 minutes.

Are there any risks in having the Dobutamine Stress Echocardiogram?

Serious risks are very rare and include ventricular tachycardia/ abnormal beating of heart (1/700 patients), heart attack (1/5,000), death (1/10,000) and allergic reaction (1 in 1,000 to 10,000 patients).  If you have had allergic reactions to any medicine previously, please inform your doctor before starting the test.

What happens after the Dobutamine Stress Echocardiogram?

We will offer light refreshments (tea/coffee and biscuits).

You will be able to resume normal activities after the test has been completed.

In the highly unlikely event of experiencing any complication after you have left the clinic; please go to your nearest Accident and Emergency Department.

We will interpret the echo and ECG recordings and provide your referring doctor with a written report. We do not normally provide you with any result at the time of the test.

 

The information is based on

Incidence, Pathophysiology and Treatment of Complications During Dobutamine-Atropine Stress Echocardiography. Circulation. 2010;121:1756-1767.