What is an exercise echocardiogram?
An exercise echocardiogram is also called an exercise echo or stress echo. It is a
noninvasive test. It shows how well your heart is working. It is done to check how
your heart reacts to stress or exercise. It helps diagnose disease in the arteries
of your heart.
For the procedure, you’ll first have an echocardiogram to see how your heart works
at rest. A small handheld device called a transducer is placed on your chest at certain
places and angles. The transducer sends out high-frequency sound waves. The waves
move through the skin and other body tissues to the heart. There, the waves bounce
or “echo” off of the heart structures. The transducer picks up the reflected waves
and sends them to a computer. The computer shows the echoes as images of the heart
walls and valves.
After the resting echocardiogram, you will exercise on a treadmill or stationary bicycle
for a certain period of time. You will then have another echocardiogram during peak
exercise and often just after peak exercise. The healthcare provider will compare
the resting echo images with those done during the stress phase. Muscle areas that
appear weaker during stress may mean you have disease in the arteries of your heart.
Why might I need an exercise echocardiogram?
You may need this test:
To check for coronary heart disease
To figure out how well your heart works and if the structures are normal
To be sure exercise is safe for you before you enter a cardiac rehab program, or after
you have had a heart attack or heart surgery
To test blood pressure levels during exercise
To see your heart status before surgery
To assess symptoms of shortness of breath or trouble breathing that happens with exercise
Your healthcare provider may have other reasons to advise this test.
What are the risks of an exercise echocardiogram?
Possible risks of this test are:
There may be other risks based on your health. Talk with your healthcare provider
about any concerns before the test.
How do I get ready for an exercise echocardiogram?
Your healthcare provider will tell you about the procedure. You will also be asked
to sign a consent form that gives your permission to do the test. Read the form carefully
and ask questions if something is not clear. For the exercise part of the test, plan
to wear loose, comfortable clothing and walking shoes.
You may need to fast before the test. Follow any directions you are given for not
eating or drinking before the test. In some cases, you may be told to not have caffeinated
drinks such as coffee, tea, and soda 2 to 3 hours before testing. You may also be
asked not to smoke, if you are a smoker.
Based on your condition, your healthcare provider may have other specific instructions
for you. For example, you may be told to not take medicines such as beta-blockers
before the test.
Tell your healthcare provider:
If you are pregnant or think you may be pregnant
If you take any prescription or over-the-counter medicines, vitamins, or herbal supplements
If you have a pacemaker
If you have any of these health problems:
Severe high blood pressure
Severe heart valve disease
Severe heart failure
Recent heart attack
Low red blood cell count (severe anemia)
Chronic lung diseases that affect your breathing while exercising
Muscle or bone problems that limit how you exercise
What happens during an exercise echocardiogram?
An exercise echo may be done on an outpatient basis. This means you can go home the
same day. Or it may be done as part of a hospital stay. The process may vary based
on your health and your healthcare provider’s practices. Generally, the test follows
You will be asked to remove any jewelry or other objects that may interfere with the
test. You may wear your glasses, dentures, or hearing aids if you use any of these.
You will be asked to remove clothing from the waist up and will be given a gown to
You will be asked to empty your bladder before the test.
You will lie on your left side for the first set of echo images. A pillow or wedge
will be placed behind your back for support.
You will be connected to an electrocardiogram (ECG) monitor using small, sticky electrodes.
The ECG records the electrical activity of your heart and monitors your heart during
the test. The healthcare team will watch your heart rate, blood pressure, breathing
rate, and oxygen level. The ECG tracing that records the electrical activity of your
heart will be compared with the images on the echocardiogram monitor.
The room will be darkened so that the technologist can see the images on the echocardiogram
The technologist will place warmed gel on your chest and then place the transducer
on the gel. You will feel slight pressure as the technologist moves the transducer
to get the desired image of your heart.
The technologist will move the transducer around and use varying amounts of pressure
to get images of different places and structures of your heart. The amount of pressure
should not be uncomfortable. If it does make you uncomfortable, tell the technologist.
You may hear a “whoosh-whoosh” sound if you have a certain echocardiography technique
called Doppler or color Doppler. The sound is the blood moving through your heart.
Once the first set of resting images have been taken, you will start exercising on
the treadmill or stationary bike.
You will exercise until you have reached your target heart rate based on your age
and health. Tell the technologist if you have any chest pain, leg pain, breathing
problems, severe tiredness, extra sweating, or heart flutters (palpitations). This
is at any point before, during, or after the test. If so, the test will be stopped.
Once you have reached your target heart rate, you may keep on exercising for as long
as you can. How long you can exercise is an important part of the stress test result.
Right after exercising, you will lie on the table or bed while the technologist takes
a second set of echocardiogram images.
After the test is done, the technologist will wipe the gel from your chest and remove
the ECG electrode pads. You may then put on your clothes.
Ask your healthcare provider when and how you will get the results of the test.
What happens after an exercise echocardiogram?
You may go back to your normal diet and activities, unless your healthcare provider
advises you otherwise. Generally, there is no special type of care after an exercise
echo. But your healthcare provider may give you other instructions.
You may get your test results the same day or at a later time. Ask your healthcare
provider or the technologist how and when you’ll get your results. Also ask if you
need to make a follow-up appointment.
Before you agree to the test or the procedure make sure you know:
The name of the test or procedure
The reason you are having the test or procedure
What results to expect and what they mean
The risks and benefits of the test or procedure
What the possible side effects or complications are
When and where you are to have the test or procedure
Who will do the test or procedure and what that person’s qualifications are
What would happen if you did not have the test or procedure
Any alternative tests or procedures to think about
When and how will you get the results
Who to call after the test or procedure if you have questions or problems
How much will you have to pay for the test or procedure