An echocardiogram is used to look inside the chest to get a better picture of the structure and function of the heart. This test is often performed as part of a stress test because some heart abnormalities are more distinct when the cardiovascular system is taxed, like during physical exertion. The person may be asked to walk on a treadmill or ride a bike in an effort to elevate the heart rate. The echocardiogram will be performed before the test begins and immediately following the test. The two results will then be compared to evaluate the condition of the heart.
Heart Rate 101
Heart rate is determined by a number of variables, including physical or emotional demands, drug interactions, or general physical condition. For example, a strong heart is efficient and will beat slower than a weak one. This is why an athlete may have a resting heart rate that is 20 to 30 beats below average. Stimulants like caffeine, nicotine and ginseng will elevate the heart rate. During times of stress, the automatic fight or flight response causes an elevation in the heart rate as the body prepares to fight or flee. According to MayoClinic.com, other reasons for an elevated HR can be related to alcohol abuse, obesity, hypertension or thyroid problems.
The Details
An echocardiogram provides a three-dimensional view of the heart. The image is then used to evaluate the pumping motion the heart performs. To the lay person, the image may not seem like anything recognizable, but a trained doctor can determine structural defects, heart attack damage, blood clots or tumors, and the size and functioning of the heart valves. An EKG, or electrocardiogram, is often performed at the same time to assess the heart rate and rhythm. Findings from a study conducted by Dr. Colomba Falcone and colleagues and published in the September 2005 issue of "Circulation" suggests that a significant heart rate increase at the start of a stress test is a strong predictor of future cardiac events, including death.
Common Reasons for Elevated Heart Rate
A common reason for an elevated heart rate is simple stress response; in other words, anxiety. Any medical test can be stressful, bringing with it anxiety about the procedure itself or about the upcoming test results. Stress can cause an elevated heart rate.
A previous heart attack can result in an elevated heart rate as well, especially if the damage was significant. A heart attack causes tissue death; this lifeless cardiac tissue does not contribute to the pumping motion of the heart and can actually interfere with the squeezing action. This inefficiency means the heart has to pump faster. A previous heart attack can also interfere with the heart's electrical conduction system, causing the heart to race for no apparent reason.
If there is a significant amount of plaque buildup in the coronary arteries, this can cause an elevated HR. If the heart feels it is not getting enough oxygenated blood, the heart will beat faster in an effort to provide itself with more oxygen.
If the body is fighting off an infection, this too can cause an increase in heart rate, as can over-the-counter cold medicine containing pseudoephedrine, cautions MayoClinic.com.
Personal Signs and Symptoms
An elevated heart rate can be a sign of an underlying problem, and the doctor will determine the most appropriate course of treatment. The doctor will evaluate the heart rate variability as well as any underlying symptoms experienced by the person, like heart palpitations, dizziness or chest pain. Treatment options are numerous, ranging from lifestyle interventions to prescription medications or surgery.
Risk Management
Lifestyle interventions that may be effective at lowering heart rate include smoking cessation, weight loss, and careful evaluation of all medications and supplements. It is advisable to keep blood pressure and diabetes under control. It is also important to limit alcohol use and find effective ways to manage stress.
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