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Exercise Stress Echocardiogram

Exercise Stress Echocardiogram - What it is

Stress Echocardiogram is a diagnostic procedure combining: 

a) Echocardiography (ultrasound), which uses high frequency sound wave to assess motion of the heart muscle; and
b) Stress test, which assesses the capacity and reserve of heart muscle function under stressful situations or exercise conditions. 
 
The information obtained will help the doctor to indirectly assess the status of blood supply to the heart muscle. It also provides indirect information on the viability and the function of the heart muscle. This information is important and vital to the doctor in planning further appropriate measures and treatment for you.
There are two ways we can stress your heart: one is using medication to stress the heart, simulating an exercise environment (Pharmacological Stress Echocardiogram). Whereas, for this Exercise Stress Echocardiogram, it will be via the treadmill test. 

Exercise Stress Echocardiogram - Symptoms

Exercise Stress Echocardiogram - How to prevent?

Exercise Stress Echocardiogram - Causes and Risk Factors

Is the test safe?

The test is usually performed on patients suspected of having or already have had coronary artery disease – insufficient blood supply to the heart muscle. 
 
Possible adverse side effects for treadmill stress echocardiography include: 
Life-threatening heart rhythm (<0.2%)
Acute myocardial infarction (0.1%)
Death (0.1%) 
Fall 
As the test involves echocardiographic imaging using ultrasound waves, there is no risk of radiation exposure. 

If you are not keen for this procedure, you will need to discuss with your doctor in your next clinic visit. If you are unable to exercise on a treadmill machine, you may then be requested to undergo another test that may involve use of medication (Pharmacological Stress Echocardiogram), radionuclide myocardial perfusion scan, magnetic resonance stress imaging. 

Can I undergo the test if I am not feeling well?
If you are feeling unwell because of fever, running nose or acute illness, you should not proceed with the procedure. Please call the NHCS Call Centre at +65 6704 2000 to reschedule the test.

Exercise Stress Echocardiogram - Diagnosis

Exercise Stress Echocardiogram - Treatments

How is the test done?

Before the exercise stress echocardiogram test begins, the doctor will assess to ensure that you are fit to undergo the test. Thereafter, the medical technologist (MT) will place the electrodes on your chest, and blood pressure cuff around your arm. 

There are 3 stages to this test:
 
Stage 1 
You will be asked to lie on your side, whereby a baseline echocardiogram will be performed involving the use of a transducer, which will be placed over your chest to obtain pictures or images of motion of the heart muscle. The images will be recorded. 
Stage 2 
You will then be asked to walk on the treadmill machine. The speed and inclination of the slope will increase every 2-3 minutes to stress your heart gradually. Once you reach the targeted heart rate, or are unable to continue because of fatigue, or if you developed symptoms such as breathlessness, chest pain, or when your doctor asks you to stop, you will then need to lie on the couch on your left side (scanning position) immediately. 
Stage 3 
Another echocardiographic recording will then be performed right after the exercise. The views of the pre-exercise images will be compared with that of the immediate post-exercise images. 

The entire procedure will take around 1 to 2 hours and this does not include the waiting time.

Exercise Stress Echocardiogram - Preparing for surgery

Preparations before test

Confirm with your doctor if you are required to stop your medication for hypertension (high blood pressure) 3 days before the test.
Take a light meal if your test is scheduled in the afternoon.
Do not apply lotion, oil, or powder to the chest.
Bring your running shoes, socks, exercise attire and towel. Socks are also available at $2.00/pair. It is necessary to wear socks if you are using the running shoes provided by NHCS.
For men, please shave your chest before coming so that the ECG electrodes can be placed on your chest.
Informed consent prior to the test is required. For patients below 21 years old, please be accompanied by a parent for consent taking.

Exercise Stress Echocardiogram - Post-surgery care

What can I expect after the procedure? 

You will be monitored for some time after the procedure if you do not feel well. If the symptoms persist, you may be admitted for observation. If the test turns out to be abnormal, you may also be admitted for further management after discussion with your doctor. 

Exercise Stress Echocardiogram - Other Information

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