STRESS ECHOCARDIOGRAM
What is a stress echocardiogram?
This test involves comparing images of the contraction of your heart at rest and following exercise.
Commonly referred to as a ‘stress echo’, this test involves an echocardiogram taken before and after an exercise stress test. 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 exercise. This may indicate severe coronary artery disease. Exercise testing measures the performance and capacity of your heart and blood vessels, to determine whether your heart receives enough oxygen and proper blood flow when you are under stress (e.g., exercising). There are instances where people are unable to exercise to increase their heart rate. A pharmacological stress test called a Dobutamine Stress test is available. Medication is given via a vein to increase the heart rate without the need to exercise. CLICK HERE
Why do I need to have a STRESS echocardiogram?
Your doctor will request a stress echo to evaluate you for coronary artery and valve disease.
This is a painless, non-invasive test.
Echocardiograms are taken before and after exercise to assess your heart function. Electrocardiographic (ECG) and blood pressure readings are taken throughout the test.
A treadmill is used to test your heart’s response to exercise. The workload (speed and incline of the treadmill) is gradually increased every three minutes. The test is stopped when you are too tired to continue or once you have achieved more than 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.
The test may be stopped prematurely if you develop any symptoms of chest pain, heart rhythm disturbances, breathlessness, or fatigue, 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?
Wear comfortable clothing and walking shoes.
You should tell your doctor about any conditions or symptoms that may make exercising difficult for you, e.g. arthritis.
Can I eat or drink before my test?
There is no need to fast before the test, however, you should refrain from having a heavy meal prior to exercise.
Do I take my medications on the day of the test?
Please check with your doctor and only stop taking medications if your doctor tells you to do so.
You may be asked to stop taking beta-blockers on the day of your test (if so, bring them along to be taken after the test).
Examples of beta-blockers:
- Atenolol (Tenormin, Noten)
- Metoprolol (Betaloc, Minax, Lopressor, Metohexal)
- Sotalol (Sotacor, Sotahexal)
- Propranolol (Inderel)
- Bisoprolol (Bicor)
- Carvedilol (Dilatrend)
- Nebivolol (Nebilet)
Where do I go to have the test?
Peninsula Heart Centre offers stress testing daily at three locations:
- Frankston Suite 11, Peninsula Private Hospital, 525 McClelland Drive
- Mornington Suite 7, Beleura Private Hospital, 925 Nepean Highway
- Albury 1142 Pemberton Street
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 comfortable clothing and walking shoes
How much will it cost?
All stress echocardiograms at the Peninsula Heart Centre are bulk billed.
What happens during the test?
ECG leads will be attached 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.
You will have a baseline resting echocardiogram.
The treadmill will start slowly (2.7 km/hr) at an incline of 10%. Every 3 minutes, the treadmill will get faster and the incline will increase.
Once you have achieved more than 85% of your target heart rate on ECG (as determined by your age) or when you are too tired to continue or when the doctor detects any changes of concern with you or your ECG the treadmill will be stopped.
An echocardiogram is performed immediately after you have stopped exercising. It is essential to take these images quickly as the heart rate may recover rapidly. The team performing the test will encourage you to move rapidly from the treadmill to the bed for this reason. Note, your heart rate and blood pressure will continue to be monitored at this stage and during your recovery. Any symptoms will be evaluated in conjunction with your ECG recording and echocardiogram.
For the echocardiogram, you will be asked to lie on your side on an exam table.
The cardiac sonographer will put some water-based gel on the end of an ultrasound probe placed firmly against your skin at various positions on your chest. This enables soundwaves from your heart to be converted into moving images on the monitoring screen. The gel may feel a little cold but, otherwise, you should not experience any major discomfort during the test.
The test may be stopped prematurely if you develop any symptoms of chest pain, rapid heartbeat, breathlessness, or fatigue, 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.
How long does the test take?
Allow up to one hour for the appointment.
What are the risks?
There are no known risks involved in a standard echocardiogram. An echo does not emit radiation.
Exercise stress testing is generally considered safe however it does carry a small risk of:
- Severe drop in blood pressure (hypotension)
- Chest pain
- Collapse
- Irregular heartbeat
- Heart attack (1-2:10,000)
- Intracerebral bleed
Every effort is made to minimise these risks. At Peninsula Heart Centre, exercise stress echo testing is performed by a cardiologist with a qualified cardiac sonographer. The test is only performed in a hospital setting that has access to emergency cardiac services should any complications arise.
When will my results be available?
Our cardiologists will report the test promptly and the results will be sent to referring doctors within 24 hours. A copy will be placed in your medical history.
You will need to organise an appointment with your doctor, who will have a discussion with you about your results. The cardiologist will discuss any new or urgent result with you on the day.
Follow-up appointments with our own cardiologists will be made, if necessary.
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