Exercise Echocardigraphy

About the Procedure

Exercise Echocardiography (also exercise stress echocardiogram or exercise echo) is a procedure performed to assess the heart's response to stress or exercise by viewing its image on a video monitor. Using ultrasound and ECG simultaneously as the patient is exercising on a treadmill or stationary bicycle, images of the heart and its electrical activity are created. There are four types of echocardiography which may be used alone or jointly: the standard M-Mode - the image is one-dimensional and appears graph-like; a Doppler - measures and assesses blood flow through the heart, and may record it; a Color Doppler - indicates direction of blood flow with colors; Two-Dimensional - image shows actual heart structures in motion. The exercise echo gives the doctor more information than an exercise stress test, which uses only an electrocardiogram (ECG), in evaluating a patient's ability to exercise safely and identifying reasons for when exercise leads to chest pain or elevated blood pressure.

The entire test takes one hour and is performed by a trained technologist in an echo lab of a hospital or out-patient facility. There are three parts to this procedure, the first part is a resting echocardiogram to get a baseline picture of the patient's heart without the stress of exercise, the second part is exercising while the heart and blood pressure are monitored, and the third part is another echocardiogram to compare against the resting one. The patient lies on a table and is connected to an ECG machine and other devices to monitor vital signs. A warm gel is squeezed onto the chest and a transducer (appears like a microphone) spreads the gel around the chest obtaining images of the heart from different positions. The patient will then exercise on a treadmill or stationary bicycle while connected to an ECG and blood pressure machine. Exercise continues until a few minutes after reaching the predefined target heart rate or until he/she is unable to continue due to physical reasons. When the exercise part is over, the patient lies down again and another echocardiogram is performed.

What to Know Before the Procedure

An exercise echocardiogram puts stress on the heart which may lead to chest pain, significantly elevated high blood pressure, irregular heartbeats (arrhythmias), dizziness, nausea, extreme fatigue, and in rare situations, a heart attack. It is considered a safe test which can provide life-saving information.

There is little preparation required for the exercise echo. Patients will be advised regarding food and drink restrictions, especially caffeine, prior to the procedure. All medications must be reviewed with the physician so as to avoid any interference with test results.

What to Know After the Procedure

Immediately following the procedure, the patient will be monitored and, if no complications are evident, they will be discharged. Normal activities and diet can be resumed unless otherwise advised by the physician.

A radiologist will review the images and other information obtained during the test and their report will be sent to the physician within a few days. Treatment plans and/or lifestyle changes can be discussed with the doctor.

If you Need to Travel Outside of your Local Hospital

The exercise echocardiography study is a common procedure with few complications and many qualified technologists and facilities perform it. Long-distance or international travel for this procedure would not be restricted by the after effects of the procedure or a limited activity level. Due to the commonality of the procedure it may not seem cost effective to have it done abroad on its own. However, this procedure may be done in conjunction with others that have more benefits to long-distance travel.