What Is The Best Test To Check For Heart Problems
Candidates For A Stress Echo
Your doctor may order a stress echo if you have been experiencing chest pains, angina, or had a recent heart attack. It can also be used as a part of the pre-surgery workup or before beginning an exercise program.A stress echocardiogram will help determine:
- How well the heart muscles and valves are functioning
- How the heart handles physical activity
- If you are likely to have coronary artery disease
- If your heart function has improved after cardiac treatment
- If you have an enlarged chamber of the heart
The test results can help your doctor determine if you have an issue with your heart muscle, and if so, what the best treatment course for your case. Results can also help your doctor evaluate whether the current treatment plan is effective.
Why May I Need An Exercise Stress Echo
This test is used to check for heart damage, blockage, or problems with the heart walls. The test can help caregivers create an exercise plan for you. Caregivers may also use an exercise stress echo to do any of the following:
- Find the cause of symptoms such as chest pain, shortness of breath, and weakness
- Monitor or diagnose a heart condition, such as heart disease or arrhythmias
- Monitor how your heart responds to a medicine or treatment
- Check your risk for a heart attack
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How Do I Prepare For A Stress Echo
- Caffeine and nicotine can affect your test results. Do not have caffeine for at least 24 hours before your test. This includes drinks, foods, and medicine with caffeine. Do not smoke 3 hours before your test or as directed. Your healthcare provider may tell you not to eat or drink anything 2 hours before your test.
- Your healthcare provider will tell you what medicines to take or not take on the day of your test. You may be told to stop taking medicine with theophylline 48 to 72 hours before your test. You may also be told to stop taking beta blocker medicine 24 hours before your test. Wear comfortable clothes and shoes if you will exercise during the test. If you have an inhaler, bring it with you to the test.
Reasons To Get The Echo Test Done
Different types of echo tests are performed top judge distinct parameters within the heart. The Transthoracic test detects the presence of any abnormality in the heart. It detects the movement and thickness of the heart wall and check for the functioning of the heart valve. Ailments such as cardiomyopathy, tumors, and blood clots are conveniently detectable with the help of this procedure.
The transthoracic echo test is, on the other hand, helps find out congenital defects within it. If a patient has met with a surgery then its efficacy is easily detectable with this test. Therefore, if you have met with a heart failure or a heart attack or suspect of thickening of lining around the heart, or collection of fluids around the heart, then all this is detectable only through this test.
Doppler echocardiogram measures the speed of the blood traveling to the heart through the vessels. It is the test done to measure blood pressure and blood speed through different heart valves. Lastly, the stress evaluation monitors and identifies the reduction of blood flow to the heart muscles. Such a situation can occur due to high stress level and is combat with intake of medicine and exercise.
Preparing for the Echo Test
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What Is A Stress Echocardiogram
This is a test that allows your doctor to compare images of your heart muscle at rest with how it functions when stressed during exercise. Your heart rate is increased through exercise on a treadmill. In some cases, a drug is used to increase the heart rate rather than using exercise. An echocardiogram is performed before you begin exercising and then immediately after you stop. Your heartbeat and blood pressure are also monitored during your stress echocardiogram.
What Happens During An Echocardiogram
Youâll be given a hospital gown to wear. Youâll be asked to remove your clothing from the waist up. A cardiac sonographer will place three electrodes on your chest. The electrodes are attached to an electrocardiography monitor that charts your heart’s electrical activity.
The technician will ask you to lie on your left side on an exam table. They will place a wand on several areas of your chest. The wand will have a small amount of gel on the end.
Sounds are part of the Doppler signal. You may or may not hear the sounds during the test. You may be asked to change positions several times so the technician can take pictures of different areas of your heart.
You should feel no major discomfort during the test. You may feel coolness from the gel on the transducer and a slight pressure of the transducer on your chest.
The test will take about 40 minutes. After the test, you can get dressed and go back to your daily activities.
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Key Points About Stress Echocardiogram
- A stress echo is a test used to determine if your heart is getting sufficient blood and oxygen supply while exercising. It may also be used to determine how well cardiac procedures such as bypass grafting, angioplasty, or antiarrhythmic medications are working.
- During a stress echo, you will walk or run on a treadmill while your doctor monitors your heart rhythm and blood pressure. When your heart rate reaches a predetermined level, your care team will take an ultrasound of your heart.
- In preparation for a stress echo, your doctor will give you a series of instructions. Follow those instructions closely to ensure the quality of the results.
- A test lasts 45 – 90 minutes. Your doctor will review your test results after the test. A normal result means you do not appear to have coronary artery disease. An abnormal result means you may have some coronary blockage.
When Is A Stress Echocardiogram Ordered
Stress echocardiograms are often done to:
- Evaluate chest discomfort possibly due to reduced flow of blood through the coronary artery
- Evaluate symptoms of shortness of breath
- Evaluate heart rhythm abnormalities
- Evaluate a patients response to treatment he has been receiving or prior heart procedures
- Evaluate a patients overall exercise capacity
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Preparing For Your Procedure
Do not eat or drink anything for at least two hours prior to your echo stress test. Check with your physician to determine if any of your medications should be avoided for the days leading up to your scheduled test. Make sure to bring all of your medications, as well as any herbal or dietary supplements and over-the-counter medications, to the test with you. Your physician can give you special instructions for necessary medications. Avoid caffeine for at least 24 hours prior to your echo stress test. Make sure to wear comfortable clothing and shoes to your test, and avoid using lotion, oil, perfume or powder on your chest beforehand.
On The Day Of Your Test
- For six hours prior to your test: Do not consume anything with caffeine.
- For two hours prior to your test: Do not eat, drink or smoke.
- Take your usual medications unless otherwise directed by your physician. Bring all of your medications with you in the original bottles.
- Wear comfortable clothes and shoes.
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What Is A Dobutamine Stress Echocardiogram
An echocardiogram is a test used to assess the heart’s function and structures. A stress echocardiogram is a test done to assess how well the heart works under stress. The stress can be triggered by either exercise on a treadmill or a medicine called dobutamine.
A dobutamine stress echocardiogram may be used if you are unable to exercise. Dobutamine is put in a vein and causes the heart to beat faster. It mimics the effects of exercise on the heart.
During an echo, a transducer sends out ultrasonic sound waves at a frequency too high to be heard. When the transducer is placed on the chest at certain locations and angles, the ultrasonic sound waves move through the skin and other body tissues to the heart tissues, where the waves bounce or “echo” off of the heart structures. The transducer picks up the reflected waves and sends them to a computer. The computer displays the echoes as images of the heart walls and valves.
A DSE may involve one or more of these special types of echocardiograms:
How The Test Is Performed
This test is done at a medical center or health care provider’s office.
A resting echocardiogram will be done first. While you lie on your left side with your left arm out, a small device called a transducer is held against your chest. A special gel is used to help the ultrasound waves get to your heart.
Most people will walk on a treadmill . Slowly , you will be asked to walk faster and on an incline. It is like being asked to walk fast or jog up a hill.
In most cases, you will need to walk or pedal for around 5 to 15 minutes, depending on your level of fitness and your age. Your provider will ask you to stop:
- When your heart is beating at the target rate
- When you are too tired to continue
- If you are having chest pain or a change in your blood pressure that worries the provider administering the test
If you are not able to exercise, you will get a drug, such as dobutamine, through a vein . This medicine will make your heart beat faster and harder, similar to when you exercise.
Your blood pressure and heart rhythm will be monitored throughout the procedure.
More echocardiogram images will be taken while your heart rate is increasing, or when it reaches its peak. The images will show whether any parts of the heart muscle do not work as well when your heart rate increases. This is a sign that part of the heart may not be getting enough blood or oxygen because of narrowed or blocked arteries.
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What Should I Do If I Have Diabetes
The guidelines are a bit different if you have diabetes:
If you take insulin to control your blood sugar, ask your doctor what amount of your medication you should take the day of the test. Often, your doctor will tell you to take only half of your usual morning dose and to eat a light meal 4 hours before the test.
If you take pills to control your blood sugar, do not take your medication until after the test is complete unless otherwise directed by your doctor.
Do not take your diabetes medication and skip a meal before the test.
If you own a glucose monitor, bring it with you to check your blood sugar levels before and after your test. If you think your blood sugar is low, tell the lab personnel immediately.
Plan to eat and take your blood sugar medication following your test.
Can I Eat Or Drink On The Day Of The Test
- Yes. However, DO NOT eat or drink anything except water for four hours before the test.
- Avoid all products that contain caffeine for 24 hours before the test. In general, caffeine is found in coffee, tea, colas and other soft drinks, most chocolate products, as well as strawberries , as caffeine will interfere with the results of the test. Also avoid decaffeinated or caffeine-free products for 24 hours before the test, as these product contain trace amounts of caffeine.
- DO NOT SMOKE ON THE DAY OF THE TEST, as nicotine will interfere with the results of your test.
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Preparing For The Test
Do not eat or drink for 6 hours prior to the test, except for water. This will help prevent nausea which may occur with the infusion of dobutamine. Do not smoke at least 4 hours prior to the test. Do not apply lotions, oils or powders to the chest area. If you are currently taking any heart medications, check with your doctor. You may be instructed to take some medications with sips of water. Consult your doctor if you are diabetic. You may be asked to hold your insulin until after the test. Wear comfortable clothing.
What Happens During A Dobutamine Stress Echocardiogram
A dobutamine stress echocardiogram may be done on an outpatient basis or as part of your hospital stay. Steps may vary depending on your condition and your doctor’s practices.
Generally, a DSE follows this process:
You will be asked to remove any jewelry or other objects that may interfere with the test. You may wear your glasses, dentures, or hearing aids if you use any of these.
You will be asked to remove clothing from the waist up and will be given a gown to wear.
You will be asked to empty your bladder before the test.
An intravenous line will be started in your hand or arm before the test. Its needed for injection of the dobutamine and to give you IV fluids, if needed.
You will lie on your left side on a table or bed, but may be asked to change position during the test.
You will be connected to an electrocardiogram monitor that records the electrical activity of your heart and monitors your heart during the test using small electrodes that stick to your skin. Your vital signs will be monitored during the test. The ECG tracing that records the electrical activity of your heart will be compared to the images displayed on the echocardiogram monitor.
The room will be darkened so that the images on the echo monitor can be seen by the technologist.
The technologist will place warmed gel on your chest and then place the transducer on the gel. You will feel a slight pressure as the technologist positions the transducer to get the best image of your heart.
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What Is A Stress Test
A stress test, sometimes called a treadmill test or exercise test, helps your doctor find out how well your heart handles its workload. As your body works harder during the test, it requires more fuel and your heart has to pump more blood. The test can show if theres a lack of blood supply through the arteries that go to the heart.Taking a stress test also helps your doctor know the kind and level of physical activity thats right for you.
Why do people need stress tests?
Doctors use exercise stress tests to find out:
- If you have an irregular heartbeat
- If your symptoms are related to your heart.
- How hard you should exercise when you are joining a cardiac rehabilitation program or starting an exercise program.
- How hard you should exercise when you are joining a cardiac rehabilitation program or starting an exercise program.
- If treatments you have received for heart disease are working.
- If you need other tests to detect narrowed arteries
How do I prepare for a stress test?
- Tell your doctor about any medicines you take. He or she may ask you not to take them before the test. Dont stop taking them unless the doctor says to.
- You may be asked not to eat, drink or smoke for two to four hours before the test. You may drink water.
- Wear comfortable, loose-fitting clothing and walking shoes with rubber soles. Shorts or sweatpants and jogging or tennis shoes are good choices.
Why The Test Is Performed
The test is performed to see whether your heart muscle is getting enough blood flow and oxygen when it is working hard .
Your doctor may order this test if you:
- Have new symptoms of angina or chest pain
- Have angina that is getting worse
- Have recently had a heart attack
- Are going to have surgery or begin an exercise program, if you are at high risk for heart disease
- Have heart valve problems
The results of this stress test can help your provider:
- Determine how well a heart treatment is working and change your treatment, if needed
- Determine how well your heart is pumping
- Diagnose coronary artery disease
- See whether your heart is too large
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Learn More About Heart Health Cardiology And Testing Options
We lead into this article with some staggering stats about heart disease in this country. The good news is, heart disease is preventable, and there are treatments for those that have already been diagnosed via a stress echo test or other means.
Be proactive! Our blog is a great resource for learning more about heart health, telecardiology, echocardiograms, and more. Check it out today!
What Happens During The Transesophageal Echo
Before a transesophageal echo, you will be asked to remove any dentures and lie down on your left side on the exam table. You will be given some IV fluids and some medicine to help you relax. Your heart rate and blood pressure will be monitored throughout the procedure. Finally, an anesthetic spray may be sprayed into your throat to reduce the gag reflex.
Then a small transducer attached to a long tube is inserted into your esophagus through your mouth. This won’t affect your breathing, but swallowing may be affected temporarily. Next, the doctor will perform the test to visualize the heart.
When completed, the tube is withdrawn. Vital signs will be monitored for about 20-30 minutes. You cannot eat or drink until the anesthetic spray wears off — about an hour.
The test takes about 30 minutes to perform.
You will need to arrange transportation home since you may feel groggy from the sedative.
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