Exercise stress echocardiogram: when is it necessary?

Exercise is the key to a healthy heart, body and life. However, if a person is suffering from heart or chest problems, exercise can put further strain on the heart. An exercise stress echocardiogram is one method of assessing the heart. Here to explain more about the test, including when it is required, is renowned consultant cardiologist Dr Sothinathan (Nathan) Gurunathan.  

What is an exercise stress echocardiogram and why is it performed?

An exercise stress echocardiography is an excellent test which is used for the assessment of the heart, particularly in cases when an individual has breathlessness or chest pain. It can also assess a person’s risk of developing heart problems.

The majority of cardiac tests are performed when patients are stationary. However, most cardiac symptoms occur during exercise and an exercise echocardiography allows the assessment of the heart when exercising.

An exercise echocardiography may be used to assess the heart in the following circumstances:

• If the doctor suspects that the patient has symptoms which may be due to narrowed or blocked blood vessels (coronary artery disease)
• To assess functional capacity and fitness and whether it is safe to exercise.
• To look for a cardiac cause of unexplained breathlessness, particularly in older people or individuals with diabetes or high blood pressure
• A recurrence of symptoms in individuals with previous heart procedures, such as coronary stents or bypass surgery
• To assess the heart prior to surgery involving other parts of the body e.g. orthopaedic procedures.
• For vocational reasons; in workers such as pilots and HGV drivers.
• To assess the heart valves further in depth.

Studies demonstrate that a normal exercise stress echocardiogram is associated with a very low risk of a heart attack during follow-up. For individuals who are unable to exercise, a pharmacological (dobutamine) stress echocardiogram can be performed.

How should I prepare for a stress echocardiography test?

It is advisable for patients to wear comfortable clothing for the test and wear shoes that will not slip off the feet. Trainers are the most ideal option.

There are certain medications that will need to be stopped for 48 hours prior to the test. The doctor can provide advice about which medications require this.

There are some medications that will need to be stopped for 48 hours prior to the test and we will advise you of this.

Are there any risks or side effects associated with stress echocardiograms?

An exercise stress echocardiogram is very safe. In fact, it is one of the safest cardiac procedures for this purpose. The level of exercise you will be asked to do is on the same level as climbing the stairs or carrying heavy shopping.

What can I expect during the stress echocardiography procedure?

Before the test, you will be asked to remove any clothing from the waist up and then lie down on an echocardiography bed on your back.  You will be given a hospital gown to wear. The cardiologist will then place sticky patches (electrodes) on your chest, which are connected to the echo machine and the treadmill.

The first echocardiogram is performed before exercise, in order to allow the specialist to see what your heart is doing when you are resting. You will then be asked to walk on the treadmill, which will start with a slow walk and gradually increase in speed every 3 minutes (using a protocol called the Bruce Protocol).

The specialist will then repeat the echocardiogram immediately after treadmill exercise.

If you are concerned about your heart and would like to book a consultation with Dr Gurunathan, simply visit his Top Doctors profile today.