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Exercise Echocardiography (Stress Echo)

An exercise stress test can be done with echocardiography (ultrasound) to increase the sensitivity (accuracy) of the test. The echo portion will also give information on the heart valves, chamber sizes of the heart and pressure in the heart and lungs. The additional imaging is particularly beneficial for women undergoing exercise tests, as women are more likely to have EKG and valve abnormalities that are benign. Echo (ultrasound) or nuclear pictures will better help the physician determine whether changes on your EKG are stemming from heart disease, or a heart-related cause of symptoms, such as shortness of breath or chest or upper back pain.

A few benefits of exercise echos are:

  • less expensive
  • decreased testing time
  • no exposure to radiation
  • more complete cardiac (heart) exam
  • some studies indicate increased accuracy for women over nuclear testing.

Test procedure

  1. You will be asked to lie on your side for approximately 10 to 20 minutes. The echo tech will put gel on your chest to record movement of your heart by moving a transducer (probe) around your chest. The echo uses ultrasound waves to create moving pictures of the heart that are recorded digitally.
  2. The exercise technician will then place electrodes (small adhesive patches) on your chest, wrists and ankles. A belt will be wrapped around your waist, which has lead wires that will be connected to the skin electrodes.
  3. You will lie down on your back for a few minutes while electrocardiograms (EKG) and a blood pressure are obtained. You will have an additional EKG and blood pressure measurement taken while standing. These initial steps are taken to ensure there are no significant abnormalities that would prevent your test from being done.
  4. You will be asked to walk on a treadmill for approximately 5 to 15 minutes. The test begins slowly and increases gradually in speed and incline every two to three minutes. During this time, your heart rate, blood pressure and EKG will be monitored.
  5. You should inform the test supervisor of any developing symptoms (leg pain, chest pain, dizziness, lightheadedness, shortness of breath). If there are any abnormal responses the test can be stopped.
  6. Your responsibility is to exercise to the best of your ability (it is not an absolute maximum effort but should be a level higher than you would typically perform at home). The exercise portion will be completed once you have attained a target heart rate (pre-determined by age). You will then move quickly to the examination table.
  7. A second echo will be done quickly to record pictures of your heart while it is still working hard (beating fast) from the exercise.
  8. When your blood pressure and heart rate are close to your initial or resting values, you will be disconnected from the monitor.
  9. The exercise technician will give you preliminary results for the walking part of your test.
  10. A cardiologist will review the test and interpret it for your follow-up visit or for forwarding to your referring physician.

Allow approximately 45 to 60 minutes for the procedure, including preparation and the exercise and recovery periods.

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