Exercise stress echocardiograms offer clinicians a sample of how your heart works when you are at rest and when your heart is "stressed." Exercise is considered a clinical stressor, as well as pharmacological agents such as dobutamine or adenosine. Stress echocardiograms diagnose cardiac muscle ischemia -- inadequate blood supply to the heart -- and reveal the condition of your coronary arteries. Testing in stress echocardiograms involves using either a treadmill or stationary bicycle.
Treadmill Stress Testing
Treadmill stress ECHOs are the most common form of exercise imaging performed. The test lasts 30 to 60 minutes, 10 to 15 minutes of which is done walking on a treadmill. During your exercise on the treadmill, the cardiology tech monitors your blood pressure and heart rate and rhythm. The treadmill is incrementally increased in speed and elevation. You exercise until you have reached your target heart rate based upon your age. Your health care provider will end the test early if you experience any complications such as dizziness, chest pain, nausea or abnormal deviations of heart rate and rhythm. After the treadmill test, a cardiology tech performs an ultrasound of your heart.
Stationary Bicycle Stress Testing
The Cleveland Clinic indicates that although the stationary bike version of the stress ECHO is not as commonly used as the treadmill, it is administered in a similar fashion. The bicycle stress test involves increasing the amount of exercise intensity over a period of seven to 12 minutes. Once you achieve your target heart rate or experience dizziness, chest pain or nausea, the cycling test ends and the tech performs the ultrasound of your heart just like in the treadmill version. The only difference is the nature of the exercise; whether you are walking up treadmill hills or bicycling as if you're in an indoor class.
Non-Exercise Stress Echocardiogram
If you have a physical condition that prevents you from walking on a treadmill or bicycling, then your clinician will administer a pharmacological-based stress ECHO called a dobutamine or adenosine stress test instead. The most common are the dobutamine stress tests. These tests involve administering the drug intravenously as a form of cardiac stressor. These drugs increase your heart rate as would occur during exercise. This continues until you reach your target heart rate.
References
- "The American Journal of Cardiology"; Usefulness of Stress Echocardiography for Risk Stratification and Prognosis of Patients With Left Ventricular Hypertrophy; Sripal Bangalore, M.D.; Feb 15, 2007
- "Cardiology Clinics"; Three-Dimensional Stress Testing: Volumetric Acquisitions; Masaki Takeuchi, M.D. and Roberto Lang, M.D.; May 2007
- "Stress Echocardiogram"; Donald Warkentin, M.D.; 2010
- "Cleveland Clinic: Current Clinical Medicine 2nd Edition"; Cleveland Clinic; 2010
- "Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine 8th Edition"; Peter Libby, M.D., et al.; 2007
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