Exercise Stress Echocardiogram

Patient Information Leaflet

Introduction

What is it?

An ultrasound scan of your heart recorded while you exercise.

• An Echocardiogram or ‘Echo’ is a scan that uses Ultrasound to produce pictures of the heart. This allows the operator to observe the movement of the heart muscle, heart valves and blood flow through the heart during exercise.
• The test is without side effects and does not use Radiation. You may feel some discomfort on your chest wall due to the positioning of the probe.
• An Exercise Stress Echocardiogram involves scanning your heart as you exercise.

Why is it being done?

• The pictures of the beating heart can show the doctor whether the heart muscle is getting enough blood supply from the coronary arteries, allowing the heart muscle to contract properly under the extra stress.

What does it involve?

• Workloads start at very low levels and, because you are monitored throughout, the test can be stopped immediately if you become distressed or the recordings are unfavourable. It is however important that you do try your best to achieve useful diagnostic information for your consultant.
• A Cardiac Physiologist and doctor will perform the scan. They will explain the test and ask you to sign a consent form to confirm that you understand the test and agree to proceed.
• We use a couch fitted with pedals which is designed to allow access to your chest for the scan. You will be seated on this couch in a semi-recumbent position (tilted slightly back and to the left) and instructed on how fast and when to pedal.
• Attend wearing comfortable, loose-fitting clothes and flat heeled firmly fitting shoes. Ladies – trousers are more practical than a skirt. You may wear sportswear if you prefer but please do not buy sportswear especially for the test, it is not necessary.
• Your height and weight will be measured. This is needed to assess the levels of work achieved during the test.
• You will be taken to a curtained area and asked to remove any clothes above the waist. This is necessary so that the physiologist can apply the electrodes to record your ECG correctly. The physiologist will need to lightly abrade the skin or sometimes shave off a little chest hair to make a good contact.
• If you require a chaperone for this procedure, please ask at the reception desk when you arrive for your appointment so this can be arranged.
• Exercise duration depends on the protocol requested by your doctor, your age and physical capabilities. Overall, the whole procedure, which includes a short rest period after exercise, should take about 45-60 minutes.
• Obtaining clear images requires concentration and a steady hand, please bear with the physiologists if they are quiet during image aquisition. Firm pressure may be required which you may find mildly uncomfortable.
• The Doctor/Cardiac Physiologist will insert a small needle (cannula) into a vein in your arm for delivery of an ultrasound enhancing agent if required.
• You can request for the rest to be terminated at any time.
• Relatives and friends will not be able to stay with you during the test (except for exceptional circumstances)

Are there any special precautions I need to take before the test?

Please bring a full list of your current medication with you.

Ladies will be issued with a gown which covers the chest area sufficiently to preserve dignity while allowing access to the chest area for scanning. Gentlemen, please ask if you prefer to have a gown.

On occasions we may need to use a drug called Atropine to help increase your heart rate, this can cause mild blurry vision. We therefore recommend that if possible, you do not drive yourself to this appointment.

Have a light meal 1 to 2 hours before the test.  If you have diabetes contact us if the appointment is at a difficult time and we will rearrange your test to suit.

Exercise is designed to increase your heart rate. There are some drugs that prevent this from happening, therefore please find below a list of medications required to be stopped 48hours prior to the test. Please check all tablets listed on both pages. Failure to stop one or a number of these medications will result in the exercise stress echo having to be rescheduled.

If you are worried about stopping these drugs for a brief time, please discuss with your GP, or alternatively, contact the echo team, who will be happy to advise. Unless advised otherwise, you should start taking these drugs following the test. You should continue to take all other drugs, prescribed for you that are not on the list, as per your usual routine, as they will not affect the result of your test.

BETA BLOCKERS:

– ATENOLOL (TENORMIN, CO-TENIDONE, KALTEN, TENORET)

– BISOPROLOL (CARDICOR, EMCOR)

– CARVEDILOL (EUCARDIC)

– ACEBUTOLOL (SECTRAL)

– NEBIVOLOL (NEBILET)

– METOPROLOL (LOPRESOR)

– PROPRANOLOL (INDERAL, HALF INDERAL)

– NADOLOL (CORGARD)

– OXPRENOLOL (TRASICOR, TRASIDREX)

– SOTALOL (SOTACOR, BETA-CARDONE)

– LABETALOL (TRANDATE)

– CELIPROLOL (CELECTOL)

– PINDOLOL (VISKIN)

– TIMOLOL (BETIM, PRESTIM)

CALCIUM BLOCKERS:

– VERAPAMIL (SECURON, UNIVER, CORDILOX, VERTAB, VERAPRESs)

– DILTIAZEM (TILDIEM, ADIZEM, ANGITIL, CALCICARD, DILCARDIA, DILZEM, SLOZEM, VIAZEM)

SINUS NODE INHIBITORS:

– IVABRIDINE (PROCORALAN)

After the test

• Once the test is complete you can get dressed and leave the department. There are no limitations as to what you can do after the scan, carry on with your normal activities-unless Atropine has been used.
• The results will be sent to the requesting doctor and will be discussed with you on your next appointment.
• Your doctor may have requested other tests and if that is the case information about them should be enclosed with this letter or separately. It is important that all the tests arranged are carried out.
• If you have any questions, please ask the cardiac physiologist or doctor.
• If you have any queries about this appointment, please call the Cardiology Department on telephone no. 01384 456111 ext. 3082

To reach the Cardiology Department proceed as follows:

Enter front foyer via the Main Hospital Entrance and turn to face the large reception desk on the left. To the right-hand side of the desk there is a set of double doors. Pass through the double doors and follow the corridor until you see the Cardiology Reception on the right-hand side.

If you do need NHS transport, please arrange this with your GP.   

If you have any questions, or if there is anything you do not understand, please contact the Russells Hall Hospital switchboard number on 01384 456111 and ask for the relevant department who issued this leaflet.

If you have any feedback on this patient information leaflet please email dgft.patient.information@nhs.net

This leaflet can be made available in large print, audio version and in other languages, please call 0800 073 0510.