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Exercise Stress Echocardiogram Information

What is an exercise stress echocardiogram?

An exercise stress echocardiogram is a screening tool that uses ultrasound imaging before and after exercise to visualize your heart function. In order to obtain good quality images, ultrasound contrast agents are used to highlight the walls of your heart. Exercise on a treadmill or stationary bike are both options.

Why do an exercise stress echocardiogram?

An exercise stress echocardiogram helps assess for:

  • Coronary artery disease: blockages in the arteries of the heart
  • Arrhythmias: abnormal heart rhythms
  • Heart rate and valvular function: your heart’s response to exercise
  • Exercise tolerance: your ability to exercise

The risk of an exercise stress echocardiogram

Stress tests are done in a controlled environment under the supervision of trained professionals. The ordering physician has screened you before ordering this test. However, some risks are associated with an exercise stress test:

  • Chest pain
  • Irregular heart rhythm
  • Fainting/collapsing
  • Heart attack (rare)
  • Adverse reaction to the ultrasound contrast (Definity) – rare

How to prepare for an exercise stress echocardiogram

Prior to arrival, you should ensure to:

  • Bring your health card
  • Bring an up-to-date medication list
    • You may be instructed to hold certain medications before the test, such as beta-blockers or calcium channel blockers. Your doctor will give you specific instructions.
  • Bring a list of your medication allergies
  • Bring inhalers if needed
  • Wear comfortable clothing and shoes

How long will the test take?

The appointment will take about 60 minutes to complete. The actual exercise time is different for everyone, but typically takes between 7 to 12 minutes.

How an exercise stress echocardiogram is performed

  • The ECG technician or Registered Nurse will explain the procedure and obtain written consent.
  • You will be asked to remove all upper body clothing and put a gown with the opening to the front.
  • Electrodes will be attached in a standard 12 lead position. The ECG Technician or Registered Nurse may have to shave the chest (if necessary) and prepare the skin with sandpaper tape and alcohol.
  • A resting ECG and blood pressure will be recorded prior to exercise.
  • With your permission, an intravenous catheter will be inserted to use a solution called Definity. Definity is an ultrasound contrast agent that is designed to improve echocardiographic ultrasound image quality. Definity is not a dye or iodine-based material.
  • The Echocardiogram Technician/Sonographer will perform a resting echocardiogram. An echocardiogram is an ultrasound of the heart that will outline the heart’s structures.
  • After the resting echocardiogram is complete, you will exercise on a treadmill or stationary bike. The ECG Technician or Registered Nurse will gradually increase the intensity of the exercise.
  • You will be monitored with continuous ECG and blood pressure monitoring.
  • The exercise portion will end when you have reached their maximum heart rate, when you desire to stop, or when another stress endpoint is reached.
  • When the exercise has been stopped, you will quickly get off the treadmill* and return to the exam table on your side so the Echocardiogram Technician can perform another echocardiogram.
    • If you are exercising on a bike, the Echocardiogram Technician/Sonographer may perform the echocardiogram while you are still pedaling.
  • Once the final echocardiogram is complete, the test is finished.

How do I get the results of my test?

After a cardiologist has reviewed your test, the results will be entered into your electronic medical record. If your cardiologist ordered the test, they will be the ones to discuss the results with you. If it was your family doctor who ordered the test, the results will be followed up by them.