What is stress echocardiogram?

ANSWER: Watch this VDO https://www.youtube.com/watch?v=-bEL_C8JacI&feature=youtu.be

Stress echocardiography is a test that uses ultrasound imaging to determine how the heart muscles respond to stress. It is mainly used to diagnose and evaluate coronary artery disease. You will exercise (treadmill or bicycle) or be given medicine until you reach the target heart rate. This helps reveal how your heart works when you are active. Your blood pressure and heart rhythm (ECG) will be monitored throughout the procedure. Echo images will be recorded during procedure. This test differs from an exercise stress test, which does not use echo images. If you cannot exercise, you will receive a medication such as dobutamine through intravenous line. This type of medicine will make your heart beat faster and harder, similar to when you exercise.

Are you eligible for this procedure?

Stress echocardiogram is indicated in patients with suspected ischemic heart disease or the followings:

-         Symptoms of angina or chest pain

-         Worsening angina

-         Recently heart attack

-         High risk for heart disease (before having surgery or when beginning an exercise program)

-         Heart valve problem

Any side effects or adverse risks?

The complication is rare. However, the following conditions can occur.

-         Abnormal heart rhythm

-         Palpitation

-         Collapse

-         Heart attack

-         Cardiac arrest/death

What would you expect before the procedure?

-         You are required to not eat or drink (except your regular medication) for at 3 hours.

-         You are required to get changes to the comfortable patient gown before the exam.

-         You will be explained and instructed about the test, and asked to sign the consent form.

-         You will be placed on blood pressure cuff over your arm, a number of ECG patches over your chest and belly for ECG monitoring

-         Echocardiogram at rest will be performed first. Then you will be asked to walk on treadmill or do a bike or given the medication. You may experience fast heart rate and bounding chest with the medication for a short period of time.  After the exercise is finished, you will be required to return to the original bed in which the echo is performed as quickly as possible within 30 seconds in order to acquire echo images at peak exercise.

Patient Preparation:

-         No oral intake for at least 3 hours before the test except regular medicines.

-         Confirm with your doctor if you need to stop beta blocker for 48 hours before you will be tested with dobutamine stress echo.

-         Wear loose, comfortable clothing.

-         Wear athletic/sport shoes

-         Let the doctor know if you think that you won't be able to walk on a treadmill.

-         You will be asked to sign a consent form before the test.

-         Prepare document of insurance.

What would you expect after the procedure?

-         You will be closely monitored.

-         You will be referred to the referral doctor to discuss about the results.

-         In case of urgency or emergency, the doctor at echocardiography lab will discuss with you and your referral doctor, and manage appropriately.

-         Generally, if the test is abnormal, coronary angiogram and/or stent placement may be required. Also, you may need to change your medicine regimen

Recommendation after the procedure:

-         No oral intake until no difficulty swallowing.

-         Do not drive within 12 hours after the procedure if sedation is used.

Location: Noninvasive Lab, Bhumisiri Building FL 4