A stress echocardiogram test, or “stress echo” for short, serves he same general purpose as a standard cardiac stress test. By observing how the heart behaves during exercise, the doctor performing or reading the test can get some clues about the kinds of problem that a person may or may not have.

The difference is that echocardiographic (ultrasound) images of the heart are obtained both at rest, before the exercise protocol begins, and immediately after exercise.  This gives additional information that can minimize some of the shortcomings of the standard stress test.

How is a stress echo conducted?

If you come for a stress echo, you will be asked to walk on a treadmill while connected to an ECG monitor.

The standard exercise protocol is the “Bruce protocol” which proceeds through stages, very easy at first, and gradually becoming more difficult. The initial stage is a low walk at a 10% incline.  With each successive stage the incline increases and the speed also increases gradually.  This allows you to warm up, to get used to the equipment and to relax before the effort gets more intense.  It also gives a chance to the doctor and the technician to observe the heart response more deliberately. Because the stress test starts off nice and easy, it provides a good opportunity to chat, exchange jokes, and get to know one another!

Once an adequate effort level is achieved, you will be asked to lie down on the examination table where images will be obtained while the heart is still pumping fast.  Any abnormal motion of the heart or abnormal pressure is noted at that point.  You can then rest for a few minutes while the ECG machine continues to record your heartbeat.