Exercise Stress Echocardiogram

What is an exercise stress echocardiogram?

An echocardiogram or ‘echo’ is a scan that uses ultrasound (sound waves) to produce pictures of the heart.  The test is painless and does not involve radiation.

During an Exercise Stress Echocardiogram, you will need to walk on a treadmill whilst pictures of your heart are taken before and after exercise.

Why is it being done?

An Exercise Echocardiogram allows your doctor to understand how the heart copes when it is made to work harder.

An Exercise Echocardiogram 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 a heart valve problem.

 How do I prepare for the Exercise 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 Exercise Stress Echocardiogram may need to be postponed.  If you have any doubts, please contact us.

You should continue other medications as usual.

Wear comfortable clothing with a separate top and bottom, comfortable flat shoes that are suitable for vigorous walking.

Do not eat any food 2 hours and do not drink any liquids 1 hour before the test.

 What does it involve?

This test will take place in an exercise stress room. Two people will usually be present when you have the test – a doctor and a cardiac physiologist.

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 also be checked regularly throughout the test.  You will be asked to lie on a couch on your left hand side and a set of pictures of your heart will be taken. A drip may be placed in the vein in your arm, if the doctor needs to inject contrast which improves the quality of the images recorded.

You will then be asked to exercise, by walking on a treadmill.  The exercise will be gentle at first but will get progressively more strenuous.

When the doctor has decided that you have performed enough exercise, or if you are unable to continue, the doctor will ask you to lie back on the couch and more images of the heart will be recorded.  You will continue to have your heart rate and blood pressure monitored until you have fully recovered, which may take several minutes.

Overall the Exercise Stress Echocardiogram takes upto 60 minutes to complete.

Are there any risks in having the Exercise Stress Echocardiogram?

Usually the investigation is considered a safe procedure.  Serious risks are very rare and include arrhythmias/abnormal beating of the heart (1 in 500), heart attack (1 patient in every 2500) and death (1 patient in every 10,000).

There is also an extremely small risk (less than 1 in 10,000) of developing an allergic reaction if contrast is used.  If you have had allergic reactions to any medicine previously please inform your doctor before starting the test.

What happens after the Exercise Stress Echocardiogram?

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 London Heart Centre; please go to your nearest Accident and Emergency Department.

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

This information is based on

Exercise Standards for Testing and Training. A Scientific Statement From the American Heart Association. Circulation. 2013;128:873-934