An echocardiogram is a noninvasive (the skin is not pierced) test used to see how
well the heart is working. An exercise echocardiogram is done to assess the heart's
response to stress or exercise and compare the results to when the heart is at rest.
During the procedure, a transducer (like a microphone) sends out high-frequency sound
waves. When the transducer is placed on the chest at certain locations and angles,
the sound 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 displays the echoes as images of
the heart walls and valves.
After the resting echocardiogram images have been taken, you will start to exercise
on a treadmill or stationary bicycle. You will exercise until your heart rate reaches
a goal for your age or to the point you start having symptoms that limit your ability
to keep exercising. The doctor will compare the resting echocardiogram with the test
done right after exercise.
An exercise echocardiogram may use one or more of these methods of echocardiography:
There may be other reasons for your doctor to recommend an exercise echocardiogram.
There may be other risks depending on your specific medical condition. Be sure to
discuss any concerns with your healthcare provider before the procedure.
Certain things may interfere with the accuracy of an exercise echocardiogram, such
Your healthcare provider will explain the procedure to you and you can ask questions.
You will 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.
You may need to fast before the test. Your healthcare provider will give you instructions
as to how long you should withhold food and liquids. In some cases, cigarettes and
caffeinated beverages, such as coffee, tea, and cola may be restricted 2 to 3 hours
If you are pregnant or think you could be, tell healthcare provider.
Tell your doctor of all medicines (prescription and over-the-counter) and herbal supplements
that you are taking.
You may be told to hold certain medicines before the procedure, such as beta-blockers.
Your provider will give you specific instructions about medicines.
Tell your doctor if you have a pacemaker.
Tell your doctor if you have the following conditions: aneurysm, severe high blood
pressure, severe heart valve disease, severe heart failure, recent heart attack, pericarditis,
or severe anemia (low red blood cell count), or chronic lung diseases that affect
your breathing with exercise.
Plan to wear loose, comfortable clothing for the exercise portion of the test, as
well as a pair of comfortable walking shoes.
Based on your condition, your provider may request other specific preparation.
An exercise echocardiogram may be done on an outpatient basis or as part of your stay
in a hospital. Procedures may vary depending on your condition and your healthcare
You will be asked to remove any jewelry or other objects that may interfere with the
procedure. You may wear your glasses, dentures, or hearing aids if you use any of
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 procedure.
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 that records the electrical
activity of the heart and monitors the heart during the procedure using small, adhesive
electrodes. Your vital signs (heart rate, blood pressure, breathing rate, and oxygen
level) will be monitored during the procedure. The ECG tracing that will record the
electrical activity of the heart will be compared to the images displayed on the echocardiogram
The room will be darkened so that the images on the echocardiogram monitor can be
viewed by the technologist.
The technologist will place warmed gel on your chest and then place the transducer
probe on the gel. You will feel a slight pressure as the technologist positions the
transducer to get the desired image of your heart.
The technologist will move the transducer probe around and apply varying amounts of
pressure to get images of different locations and structures of your heart. The amount
of pressure behind the probe should not be uncomfortable. If it does make you uncomfortable,
however, let the technologist know.
The different echocardiogram techniques described above (M-mode, 2-D, 3-D, Doppler,
and color Doppler) may be used. You will not be aware of the different techniques
except that during the Doppler or color Doppler, you may hear a "whoosh-whoosh" sound,
which is the sound of the blood moving through the heart.
Once the echocardiogram 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 (determined by the
healthcare provider based on your age and physical condition), or until you are unable
to continue due to chest pain, leg pain, severe shortness of breath, or severe fatigue.
Once you have reached your target heart rate, you may continue to exercise as tolerated,
as exercise duration is an important component of the stress test result.
Tell the technologist if you feel any chest pain, breathing difficulties, excessive
sweating, or heart palpitations.
Immediately after exercise, you will lie on the table or bed while a second set of
echocardiogram images is taken.
After the procedure has been completed, the technologist will wipe the gel from your
chest and remove the ECG electrode pads. You may then put on your clothes.
Ask your provider when and how you will get the results of your stress echocardiogram.
You may resume your usual diet and activities unless your doctor advises you differently.
Generally, there is no special type of care following an exercise echocardiogram.
However, your healthcare provider may give you other instructions after the procedure,
depending on your particular situation.