A stress echocardiogram is a type of heart examination used by doctors to help diagnose coronary heart disease. Patients are tested while exercising in order to assess the performance of the heart muscle under stress, and to see whether the heart is receiving sufficient oxygen from the blood vessels. Patients are also monitored for other abnormal symptoms that may arise during exercise, such as shortness of breath, chest pain, irregular heartbeat, and changes in heart rhythm. The use of an echocardiogram will help to discern whether or not the heart muscle is pumping sufficient blood to the rest of the body – and also allows doctors to monitor the patient’s heart rhythm and performance of the heart valves, and measure the capacity of the heart chambers. In turn, this allows the doctors to see whether the patient is suffering from coronary heart disease.
By using an echocardiogram, doctors can increase the accuracy and precision of their diagnosis, allowing for a more accurate reading than if the patient was observed while walking on a normal treadmill.
Stages of Examination (Total Duration: 60 minutes)
- A nurse will attach a set of electrodes to the patient's chest in order to monitor the heart muscle and observe the examinee's blood pressure and heart rhythm.
- The patient will lie flat on a bed to allow the nurse to conduct a heart recording and collect images of the heart using the echocardiogram before the examination.
- The patient will then come down from the bed and begin on the treadmill with a slow walk.
- The nurse will alter the speed and incline of the treadmill every 3 minutes, to simulate the patient walking up a steep hill.
- When the patient's heart rate reaches its peak and they are unable to continue, the nurse will stop the treadmill.
- The patient must then lie back down on the bed immediately, on their left-hand side, so that the nurse can conduct a heart recording and take an echocardiogram after exercise.
- When the examination is complete, the doctor will then read and explain the results to the patient, comparing the echocardiogram results from before and after exercise.
Preparations Prior to Examination
- Do not consume food or drinks 4 hours prior to the examination.
- Do not take any medications on the morning of the examination, unless advised to do so by the doctor.
- Provide documents showing all of the medication recently used for the doctor to review, as well as the doses prescribed.
- Wear loose-fitting, comfortable clothing and appropriate footwear for exercise.
- If suffering from diabetes and using insulin, use only half of the regular insulin dose, and do not eat breakfast unless advised to do so by the doctor. If using any other medications for diabetes, do not take any medication on the morning of the examination.
Precautions During Examination
Patients must inform the medical personnel immediately if they require the treadmill to be slowed or stopped, or experience the following:
- Chest pain, burning sensation or tightness in the chest
- Nausea or dizziness
Potential Risks and Complications During Examination
- Irregular heartbeat
- Syncope (fainting) – which can cause injury if the patient collapses
- Acute myocardial infarction (heart attack)
After the Examination
After the examination, the patient may eat, take their medication, and go about their activities as usual – unless instructed not to do so by a doctor.
Heart (Cardiology) Center
Bumrungrad International Clinic (BIC) Building, 14th
Bumrungrad International Hospital, Bangkok, Thailand