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Exercise Stress Echo Test

What is an exercise stress echo test?

An echocardiogram (often called an "echo") is a graphic outline of the heart's movement, valves and chambers created from high-frequency sound waves that come from a hand-held wand placed on your chest. Echo is often combined with Doppler ultrasound and color Doppler to evaluate blood flow across the heart's valves.

The exercise stress echo test involves exercising on a treadmill while you are closely monitored. The test is used to:

  • Determine how well your heart tolerates activity;
  • Evaluate the function of your heart and valves;
  • Determine your likelihood of having coronary artery disease (blocked arteries); and
  • Evaluate the effectiveness of your cardiac treatment plan.

Should I take my medications the day of the test?

24 hours before the test. Ask your physician, pharmacist or nurse if you have questions about other medications that may contain caffeine.

Your physician may also ask you to stop taking other heart medications on the day of your test. If you have any questions about your medications, ask your physician.

NOTE: Do not discontinue any medication without first talking with your physician.

  • If you use an inhaler for your breathing, please bring it to the test.

Guidelines for people with diabetes

If you take insulin to control your blood sugar, ask your physician what amount of your medication you should take the day of the test. Often, your physician will tell you to take only half of your usual morning dose and to eat a light meal 4 hours before the test.

Guidelines for people with diabetes

Wear comfortable clothes. Bring shoes suitable for walking. Do not bring valuables. You will be given a locker to store your belongings during the test.

What happens during the test?

  • A cardiac sonographer will gently rub 10 small areas on your chest and place electrodes (small, flat, sticky patches) on these areas. The electrodes are attached to an electrocardiograph monitor (EKG) that charts your heart's electrical activity during the test.
  • Before you start exercising, the sonographer will perform a resting EKG, measure your resting heart rate and take your blood pressure.
  • The sonographer will ask you to lie on your left side on an exam table so he or she can perform a resting echocardiogram (also called an "echo"). An echocardiogram is a graphic outline of the heart's movement created from ultrasound vibrations echoed from the heart's structures. The technician will place a wand (called a transducer) on your chest so the physician can see the outline of the heart's movement. This should not hurt.
  • After the echo test, you will exercise either on a treadmill or a stationary bicycle.
  • The lab personnel will ask you to start exercising and gradually increase your rate of exercise. You will be asked to exercise very hard until you are exhausted.
  • At regular intervals, the lab personnel will ask how you are feeling. Please tell them if you feel chest, arm or jaw pain or discomfort, short of breath, dizzy, lightheaded or if you have any other unusual symptoms.
  • The lab personnel will watch for changes on the EKG monitor that suggest the test should be stopped.
  • When you cannot exercise any longer, you will get off the treadmill*, quickly return to the exam table and lie on your left side so the sonographer can perform another echocardiogram.
  • If you were exercising on a bike, the sonographer may perform the echo test while you are still pedaling. You may be asked to quickly return to the exam table for another echocardiogram after exercising.
  • Your heart rate, blood pressure and EKG will continue to be monitored after exercising until the levels are returning to normal.

How will I feel during the test?

You will be encouraged to exercise until you are exhausted. It is normal for your heart rate, blood pressure, breathing and perspiration to increase. This information will allow your physician to assess your heart's ability to function.

As you stop exercising suddenly, it is normal to feel a little unsteady when getting off the treadmill and onto the exam table for the echocardiogram.

If you begin to notice chest discomfort, excessive shortness of breath, lightheadedness, irregular heart beats or other symptoms of concern, tell the stress lab personnel immediately.

How long does the test take?

The appointment will take about 60 minutes. The actual exercise time is usually between 7 and 12 minutes.

How do I get the results of my test?

After the cardiologist reviews your test, the results will go into your electronic medical record. Your physician will have access to the results and will discuss them with you.

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