What is the Stress Echocardiogram Test?

The patient has to undress from the waist up and electrodes are placed on their chest to monitor the electrocardiogram and echocardiogram data produced by the test. The patient’s blood pressure is also monitored. The test begins with the patient lying on their left side and a conductive gel is applied to allow the resting transthoracic echocardiogram to be performed and for image collection.

Next, the exercise echocardiogram is performed, either on a treadmill or on a bicycle (less frequent) whose speed, slope, and power can be incrementally increased every few minutes. The test ends when the patient cannot continue exercising any longer.

Immediately after the exercise, the person must lie down again on their left side so that a post-exercise transthoracic echocardiogram can again be performed.

Exercise has the effect of transiently increasing the amount of blood circulating in the healthy arteries of the heart without increasing it in any arteries that may be obstructed. Obstruction can be detected as the appearance of chest pain or of alterations in the electrocardiogram or echocardiography test results. In addition, exercise may reveal valve dysfunctions that may not be evident in resting echocardiography tests.

In this test the cardiac muscle is stimulated through a drug (dobutamine) that acts as an exercise simulator while at rest. It can cause a feeling of increased resting heart rate speed as well as slight facial tingling, tremors, dizziness, nausea, palpitations, and slight chest discomfort.

To administer the drug, an intravenous line is placed in the patient. The drug infusion lasts between 10 and 15 minutes.

The echocardiogram and the electrocardiogram test results, as well as the patient’s blood pressure, are then monitored. First, an echocardiogram is performed at rest, and then new echocardiograms are performed at each dose increase in the drug.

The test usually lasts an average of 45–60 minutes, after which the patient can resume their normal activities.

Although complications are rare, the following may appear:

• Thoracic pain.
• Fall, resulting from poor adaptation to the rhythm of the activity required by the treadmill.
• Feeling of shortness of breath or dizziness.
• Exceptionally (in 1 in every 1,000 tests), heart attack and arrhythmias.

• Wear comfortable clothes and sports shoes or well‑fastened comfortable shoes. For comfort, it is advisable to wear a wireless bra.
• To ensure good adhesion of the electrodes, do not apply moisturizer for a few hours before taking the test.
• Avoid eating food two hours before the test.
• Do not perform high-intensity exercise 12 hours before the test.

• Inform the medical team if you have any leg‑joint problems that could prevent you from walking at a fast pace or on a slope.
• Write down any medications you usually take in case the medical team needs to know about these.