Exercise Echocardiogram (Stress Echo)

What is an Exercise Echocardiogram? Why perform the Test?

This is an Exercise Test (see Exercise ECG), with the additional use of ultrasound pictures of the heart comparing before and immediately after the exercise. This not only makes the Exercise Test more accurate in diagnosis when looking for possible narrowings of the arteries that supply blood to the heart muscle, but also allows the cardiologist to assess the function of valves and other structures of the heart under the stress of exercise.

What happens during an Exercise Echocardiogram?

During the test the treadmill increases in speed and inclination every 3 minutes in set increments according to a protocol used by doctors all around the world.

An experienced doctor monitors blood pressure, heart rate and ECG as well as the patient. The patient is continually monitored during the test for any other signs and symptoms

During recovery the patient is also monitored to ensure a safe return to a “resting level”.

This test does not replace a 2D Echocardiogram.

Preparation before the Exercise Echocardiogram on the day of the test we recommend the following

A light meal is allowable at least 2 hours before the test.
Please do not use body lotion on your chest - this may interfere with the adhesive electrodes.
ECG patterns and some of the body’s responses to exercise can be affected by various medications, so please bring a complete list of your medications to your appointment.
You will be asked permission to perform the test.

What to Wear for the Exercise Echocardiogram Test

When you enter the test room patients are required to:

Undress to the waist, so wear a two-piece outfit and comfortable footwear
Women are given a gown to wear.
Some people bring exercising shorts / tights and walkers / joggers.

Exercise Echocardiogram Test Connections

Patients are prepared for the test by having:

Electrode sites on the chest are cleansed with alcohol wipes
Some men require a small amount of shaving to ensure good electrical contact between the electrode and skin which can be hampered by bodily movement during the test
Ten adhesive electrodes are then attached to the chest
The electrodes are connected to leads
The leads provide the signals for the ECG to record

Exercise Echocardiogram Test Stage One - Ultrasound

Testing commences with an ultrasound of your heart at rest in dimmed light.

An Accredited Cardiac Sonographer will place a special probe with ultrasound gel on various parts of the chest wall to view the heart from different angles as you rest on a bed.

An ultrasound comprising of four or five views will generally be performed from two spots –

Parasternal view (next to the sternum) whilst lying on your left side and
Apical view (edge of your chest) whilst lying on your left side.

The Sonographer may ask you to breathe in or out and hold your breath several times, which is important for recording the best pictures.

A rest ECG image will be recorded whilst standing on the treadmill.

Exercise Echocardiogram Test Stage Two - Treadmill

Stage two involves the performing a treadmill test

The treadmill exercise ECG consists of walking on a treadmill, initially very slowly.

A firm grip should be maintained on the treadmill bars throughout the test and your feet should be as far forward as possible.

You will be asked to continue for as long as possible at which point the treadmill will stop and you will be asked to quickly lie back on the bed in the same position you were in for the initial ultrasound.

The lights will be dimmed again and a similar further ultrasound will be completed immediately.