Stress Echocardiogram

A stress echocardiogram (stress echo) is a test that uses ultrasound to see how well the heart works during the stress of exercise. An echocardiogram is performed at rest then during exercise using a treadmill or a medicine which simulates exercise.

Why it’s Done

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

How to Prepare

STOP all caffeine for 48 hours before your appointment. This includes any coffee, tea, colas, energy drinks, chocolate, and cocoa

For 4 hours before the test: Do not eat or drink anything unless you are told otherwise

Check with your doctor:

  • If you are diabetic and have questions
  • If you are taking regular medicine(s): Your doctor will tell you what medicine(s) to take or not to take

Bring with you: all the medicines you are currently taking in their original containers

  • Wear comfortable clothes and walking shoes

What to Expect During the Test

You will be asked to:

  • Remove clothing from the waist up
  • Put on a hospital gown, and
  • Lie on an exam table 

EKG stickers are placed on your chest and your blood pressure and heart rate will be monitored closely by the staff. Ultrasound pictures of your heart will be taken at different times during the test.

Occasionally, saline or ultrasound contrast (dye, which is different from x-ray dye) is injected through an intravenous line to make the heart show up more clearly on the test images. 

You maybe asked to come 15-30 minutes before your actual appointment time to register

If you are having a stress echo using a medicine to simulate exercise (called a pharmacologic stress echo):

  • You will have an intravenous (IV) catheter placed in your arm
  • A medicine called Dobutamine will be given through the IV. The amount of this medicine will slowly be increased until a target heart rate is reached (determined by the doctor based on your age and physical condition)
  • Your blood pressure and heart rate will be checked often
  • You may feel anxious or shaky, short of breath, sick to your stomach, hot flashes and/or a feeling of pounding in your chest. You will be asked to tell the staff if you have any of these symptoms. If needed you will receive medicines to help control the side effects
  • Ultrasound pictures are taken and then the medicine (Dobutamine) will be stopped
  • You may be given a medicine to help bring your heart rate down
  • Once your heart rate is within normal limits more ultrasound picture will be taken

If you are having an exercise stress echo (walking on a treadmill)

  • You will be asked to walk on a treadmill until a target heart rate is reached (determined by the doctor based on your age and physical condition)
  • Your blood pressure and heart rate will be checked often
  • The speed and slope of the treadmill will be increased at regular intervals
  • You will be asked to tell the staff when you are too tired to continue and they will assist you back to the exam table 
  • Ultrasound pictures are taken while your heart is beating fast and after your heart rate is within normal limits

A stress echocardiogram takes about 1 hour to perform

After the Test

  • After the test you will have to stay at the hospital for 30 minutes. 
  • The doctor who ordered the test will receive the results and review them with you