What is the heart and how does it work?
The heart is a muscle inside your chest, which pumps blood around your body to your vital organs. It’s a special piece of plumbing, made up of four chambers with pipes into and out of it. Between each chamber, and in each of the tubes, there are valves which control the flow of blood. Your heart receives its own supply of blood full of oxygen, from a few vessels called the coronary arteries. These arteries wrap around your heart and keep it alive.
Why do I need a stress echocardiogram?
A stress echocardiogram or “stress echo” is performed to check how well your heart is functioning. If you have been having chest pain, trouble breathing or other issues, a stress echo helps doctors to see if you have coronary artery disease or have had a heart attack. It can also give information about how well treatments like coronary artery bypass graft (CABG) or medications are working.
What is a stress echocardiogram, and how is it performed?
An echocardiogram is an ultrasound scan to look at how well your heart pumps, and how the valves in your heart are working. It is a very similar procedure to the scans pregnant women have to check up on their babies. During an echo scan, some jelly will be put on the end of an ultrasound probe, which will then be placed against your chest. You may be asked to lie on your side or hold your breath at various times during the scan.
You will lie down and be scanned with the ultrasound probe before you start exercising, to see how well your heart works when you are resting. During the test, you will likely have ten sticky patches attached to your chest, arms and legs. These are electrocardiogram (ECG) leads, which will give information about the rhythm of your heart during the test. You will also have a blood pressure cuff on your arm to monitor your blood pressure during the test.
You will then walk or run on a treadmill for anywhere between 5 to 15 minutes. The speed and incline of the treadmill will increase over time. The test can also be done using a stationary bike, and during the test the speed and resistance of the bike will increase. The aim of the exercise is to make your heart beat faster. If you have chest pain or breathlessness, the test is stopped.
When your heart rate is at its fastest, the doctor will have you lie back down and will scan your heart again with the ultrasound probe. This scan is to look at how your heart is working under more strain. You will have time to cool down and catch your breath after this, if you need.
What will it tell us?
A stress echocardiogram is a reliable test that can give doctors useful information about your heart. It shows whether your heart is pumping weakly or inefficiently, due to a blockage in your coronary arteries or a previous heart attack. It helps doctors to diagnose coronary artery disease, which can then be treated to improve your quality of life. It also tells doctors if your treatment for a known heart problem is working well.
What are the risks?
There are virtually no risks associated with an echocardiogram itself – ultrasounds are not invasive and use sound waves to create images, so you are not exposed to radiation.
However, there are some risks linked to the exercise part of the test. These risks include an irregular heart rhythm (arrhythmia), chest pain, and rarely, a heart attack. You are at a higher risk of these problems if you have severe heart disease. Your doctor will take these factors into account when deciding whether to give you a stress echo. During the test, there will be emergency equipment and staff are trained to deal with these problems if they arise.
Where to from here?
Once your doctor has the results from your stress echo, they will discuss the results with you and decide on a treatment plan. The options for treatment of coronary artery disease, a past heart attack and other issues often involve exercise and rehabilitation programs, medication and sometimes surgery.