Dobutamine stress echocardiogram
What is a Dobutamine stress echocardiogram?
This test involves the use of a drug called Dobutamine which is an Adrenaline-like medication that makes the heart beat stronger and faster to simulate heart activity during exercise. This allows us to compare the contraction of your heart at rest and after exercise.
The test involves an echocardiogram with a series of images taken before the drug is started and during the infusion of the drug at various stages. The echo produces images of the heart valves and chambers so that your doctor can see how your heart is functioning and if there is evidence of heart muscle weakness during the stages of “exercise”. This may indicate severe coronary artery or valvular heart disease. Dobutamine stress testing measures the performance and capacity of your heart and blood vessels, to determine whether your heart receives enough oxygen and adequate blood flow when your heart is under stress.
Why do I need to have a Dobutamine STRESS echocardiogram?
Your doctor may request a Dobutamine stress echo to evaluate you for coronary artery and valvular heart disease.
An IV cannula will be inserted into the vein in your arm in order to administer the Dobutamine and other drugs that may be required. Echocardiogram images are taken before, during and on completion of the drug induced exercise, in order to assess your heart’s function.
The heart rate level is achieved when you reach 85% of your target heart rate on ECG (as determined by your age), or when the doctor detects any changes of concern with you or your ECG.
Once the infusion is stopped, your heart rate will return to its pretest range within approximately 2-5 minutes. Other drugs that affect the heart rate may also be given during the test if required.
The test may be stopped prematurely if you develop any symptoms of chest pain, heart rhythm disturbances or any ECG or blood pressure abnormalities.
It is important to tell your doctor if you are feeling unwell in any way or if you want to stop.
Is there any preparation required for this test?
Allow 1 hour for the test
Wear easy to remove upper garments as you will be asked to change into a gown. Ensure you are well hydrated to allow for easy vein access.
Can I eat or drink before my test?
There is no need to fast however, you should refrain from having a heavy meal prior to the test.
Do I take my medications on the day of the test?
Please check with your doctor and only stop taking medications if your doctor instructs you to do so.
STOP Beta-blockers on the night prior and the day of your test
- Atenolol (Tenormin, Noten)
- Metoprolol (Betaloc, Minax, Lopressor, Metohexal)
- Sotalol (Sotacor, Sotahexal)
- Propranolol (Inderal)
- Bisoprolol (Bicor/Bicard)
- Carvedilol (Dilatrend)
- Nebivolol (Nebilet)
STOP Calcium channel blockers on the night prior and the day of your test
- Verapamil (Isoptin)
- Diltiazem (Cardizem)
NOTIFY the Dr supervising the test if you are on these Anti arrhythmic medications
- Amiodarone (Cordarone/Aratac)
- Sotalol (sotacor)
- Digoxin (Lanoxin)
- Flecainide (Tambocor/Flecatab)
Bring your medications with you on the day so you can take them after the test.
Where do I go to have the test?
Peninsula Heart Centre offers Dobutamine Stress tests locally at two sites
- Frankston Suite 11, Peninsula Private Hospital, 525 McClelland Drive
- Mornington Suite 7, Beleura Private Hospital, 925 Nepean Highway
What do I need to bring?
Please bring your Medicare Card and personal information for our medical records (Pension/HCC/health insurance/DVA/emergency contact details) and the Referral Letter from your doctor (if not already sent).
What do I wear?
Wear easy to remove upper garments as you will be asked to change into a gown.
How much will it cost?
There is a small out of pocket cost associated with this test to cover medication and consumables.
What happens during the test?
An intravenous (IV) line will be inserted into a vein in your arm and connected to fluid that will delivered by an IV pump.
ECG leads will be attached to your chest to monitor your heart rate and rhythm throughout the procedure. A blood pressure cuff placed on your arm will record your blood pressure at 3-minute intervals during the test and until it has returned to baseline.
You will have a baseline resting echocardiogram.
The IV drug infusion will commence at a low level dose according to your weight. The Dobutamine infusion is given at increasing doses to achieve a gradual increase in heart rate. Echo images will be taken at varying stages during the test as your heart rate increases. Once a maximum target heart rate is achieved, more than 85% of your target heart rate, or if the doctor detects any changes of concern, the Dobutmine will be stopped and the final images will be taken. Once the Dobutamine infusion is stopped, the heart rate should return to normal within approximately 2-5 minutes. Sometimes the Doctor will administer medication during the test to assist in increasing the heart rate response (Atropine) and also to reduce the heart rate back to normal (Metoprolol).
It is important to tell your doctor if you are feeling unwell in any way or if you want to stop.
How long does the test take?
Allow up to one hour for the appointment. You will be asked to remain in the clinic for 30 minutes after the test.
What are the risks?
There are no known risks involved in a standard echocardiogram. An echo does not emit radiation.
Dobutamine stress testing is generally considered safe however it does carry a small risk of:
- Chest pain, breathlessness or palpitations
- Nausea
- Light headed
- Flushed feeling
- Severe drop in blood pressure (hypotension)
- Collapse
- Irregular heartbeat
- Heart attack (1-2:10,000)
- Intracerebral bleed
Every effort is made to minimise these risks. At Peninsula Heart Centre, Dobutamine stress echo is performed by a cardiologist with a qualified cardiac sonographer. The test is only performed in a clinical setting that has access to emergency cardiac services should any complications arise.
When will my results be available?
Our cardiologists immediately compare resting and “exercise” images of the heart to determine if there is evidence of poor blood flow to the heart muscle area or severe narrowing of the heart valve. You will be given a preliminary result at the time of the test and if further management is warranted. (Eg coronary angiogram )
The final report will be sent to your referring doctors within 24 hours. A copy will be placed in your medical history.
You may need to organise an appointment with your local doctor, who will have a discussion with you about your results. Follow-up appointments with our own cardiologists will be made, if necessary.
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