Stress echocardiography is a test that uses ultrasound imaging to show how well your heart muscle is working to pump blood to your body. It is most often used to detect a decrease in blood flow to the heart from narrowing in the coronary arteries.
Narrowing in the coronary arteries
Coronary heart disease is a narrowing of the small blood vessels that supply blood and oxygen to the heart. Coronary heart disease (CHD) is also cal...
This test is done at a medical center or health care provider's office.
A resting echocardiogram will be done first. While you lie on your left side with your left arm out, a small device called a transducer is held against your chest. A special gel is used to help the ultrasound waves get to your heart.
An echocardiogram is a test that uses sound waves to create pictures of the heart. The picture and information it produces is more detailed than a s...
Most people will walk on a treadmill (or pedal on an exercise bicycle). Slowly (about every 3 minutes), you will be asked to walk (or pedal) faster and on an incline. It is like being asked to walk fast or jog up a hill.
In most cases, you will need to walk or pedal for around 5 to 15 minutes, depending on your level of fitness and your age. Your provider will ask you to stop:
When your heart is beating at the target rate
When you are too tired to continue
If you are having chest pain or a change in your blood pressure that worries the provider administering the test
If you are not able to exercise, you will get a drug, such as dobutamine, through a vein (intravenous line). This medicine will make your heart beat faster and harder, similar to when you exercise.
Your blood pressure and heart rhythm (ECG) will be monitored throughout the procedure.
More echocardiogram images will be taken while your heart rate is increasing, or when it reaches its peak. The images will show whether any parts of the heart muscle do not work as well when your heart rate increases. This is a sign that part of the heart may not be getting enough blood or oxygen because of narrowed or blocked arteries.
Ask your provider if you should take any of your routine medicines on the day of the test. Some medicines may interfere with test results. Never stop taking any medicine without first talking to your doctor.
It is important to tell your doctor if you have taken any of the following medicines within the past 24 hours (1 day):
Sildenafil citrate (Viagra)
DO NOT eat or drink for at least 3 hours before the test.
Wear loose, comfortable clothing. You will be asked to sign a consent form before the test.
A normal test will most often mean that you were able to exercise as long as or longer than most people of your age and gender. You also did not have symptoms or concerning changes in blood pressure and your ECG. Your heart pictures show that all parts of your heart respond to increased stress by pumping harder.
A normal result means that blood flow through the coronary arteries is probably normal.
The meaning of your test results depends on the reason for the test, your age, and your history of heart and other medical problems.
Fihn SD, Blankenship JC, Alexander KP, et al. 2014 ACC/AHA/AATS/PCNA/SCAI/STS focused update of the guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines, and the American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2014;64(18):1929-1949. PMID: 25077860 www.ncbi.nlm.nih.gov/pubmed/25077860.
Fowler GC, Smith A. Stress echocardiography. In: Fowler GC, ed. Pfenninger and Fowler's Procedures for Primary Care. 4th ed. Philadelphia, PA: Elsevier; 2020:chap 76.
Solomon SD, Wu JC, Gillam L, Bulwer B. Echocardiography. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 14.
Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Internal review and update on 03/28/2019 by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.