What To Expect Before Echocardiography
Echocardiography is done in a doctor’s office or a hospital. No special preparations are needed for most types of echo. You usually can eat, drink, and take any medicines as you normally would.
The exception is if you’re having a transesophageal echo. This test usually requires that you don’t eat or drink for 8 hours prior to the test.
If you’re having a stress echo, you may need to take steps to prepare for the stress test. Your doctor will let you know what steps you need to take.
Drug Induced Stress Test
This test is intended to evaluate how well the heart muscle and valves are working and how they function under stress as well as the size of the hearts pumping chambers . This test is used for patients who are unable to exercise on a treadmill. The heart is stressed by using an intravenous chemical called dobutamine. This medication increases your heart rate and enables the doctor to learn how your heart functions when it is “stressed” to work harder. The rise in heart rate increases the oxygen demand of the heart and helps to determine if the heart muscle is getting enough blood and oxygen.
What Does A Stress Test Show
For men with symptoms like chest pain with activity or unexplained shortness of breath, an abnormal stress test points to a higher risk of CAD. But it’s more worrisome in a man who also has risk factors like older age, being overweight, or high cholesterol. “This points strongly to coronary artery disease.” Dr. Bhatt says. Confirming it could require further testing.
If you have symptoms and the test result looks normal, the risk of CAD is lower. “That person is less likely to have significant coronary artery disease,” Dr. Bhatt says. Even so, the doctor might still want to do more tests.
But it’s important to understand that a “normal” stress test can’t rule out the chance that a plaque will later rupture and block an arterythe proverbial tale of the man who passes a stress test with flying colors and then has a heart attack a week later. Stress testing detects arteries that are severely narrowed . This is what causes symptoms. Heart attacks often result from lesser blockages that rupture and form clots.
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How Should I Prepare For The Exercise Stress Test
- Donât eat or drink anything except water for 4 hours before the test.
- Donât drink or eat anything with caffeine for 12 hours before the test.
- Donât take the following heart medications on the day of your test, unless your doctor tells you otherwise or the medication is needed to treat chest discomfort the day of the test:
You may also be asked to stop taking other heart drugs on the day of your test. If you have questions about your meds, ask your doctor. Donât discontinue any drug without checking with them first.
How Do I Get Ready For A Dobutamine Stress Echocardiogram
Your doctor will explain the test to you and let you ask questions.
You will be asked to sign a consent form that gives your permission to do the test. Read the form carefully and ask questions if anything is not clear.
Tell the doctor if you are allergic to or sensitive to any medicines or latex.
Fasting may be required before the test. Your doctor will give you instructions on how long you should withhold food and liquids. Tobacco use and caffeinated beverages, such as coffee, tea, and soda, may be restricted several hours before testing.
Tell your doctor of all medicines , vitamins, herbs, and supplements that you are taking.
You may be instructed to hold certain medicines before the test, such as beta-blockers. Your doctor will give you specific instructions
Tell your doctor if you are pregnant or think you could be.
Tell your doctor if you have a pacemaker.
Based on your medical condition, your doctor may request other specific preparation.
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How Will I Feel During The Test
You will be encouraged to exercise until you are exhausted. It is normal for your heart rate, blood pressure, breathing rate and perspiration to increase.As you stop exercising suddenly, it is normal to feel a little unsteady when getting off the treadmill and onto the exam table for the echocardiogram.
What You May See And Hear During Echocardiography
As the doctor or sonographer moves the transducer around, you will see different views of your heart on the screen of the echo machine. The structures of your heart will appear as white objects, while any fluid or blood will appear black on the screen.
Doppler ultrasound often is used during echo tests. Doppler ultrasound is a special ultrasound that shows how blood is flowing through the blood vessels.
This test allows the sonographer to see blood flowing at different speeds and in different directions. The speed and direction of blood flow appear as different colors moving within the black and white images.
The human ear is unable to hear the sound waves used in echo. If you have a Doppler ultrasound, you may be able to hear “whooshing” sounds. Your doctor can use these sounds to learn about blood flow through your heart.
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Echo Results And The Functions Of The Heart
The resulting image of an echocardiogram can show a big picture image of heart health, function, and strength. For example, the test can show if the heart is enlarged or has thickened walls.
Walls thicker than 1.5cm are considered abnormal. They may indicate high blood pressure and weak or damaged valves.
An echocardiogram can also measure if your heart is pumping enough blood through your body.
Left ventricular ejection fraction measures the percentage is blood pushed from the heart per beat. Cardiac output is the volume of blood pumped per minute, with the adult average being 4.8 to 6.5 liters.
The hearts walls wont pump properly if the walls contract too little or too much. This may indicate a prior heart attack or heart disease.
Your echo results will also tell if the valves of your heart are opening and closing properly. If so, blood flow is normal.
The doctor will also use the overall image of the heart to look for structural defects. Defects include openings between chambers, passages between blood vessels, and fetal heart defects.
Is Echo Enough To Detect Heart Problems
Your doctor can use an echocardiogram to diagnose heart problems. The purpose of an echocardiogram is to produce images of your heart using sound waves. This is a common test that allows your doctor to see your heart beating and pumping blood. The images from an echocardiogram can be used by your doctor to diagnose heart disease.
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Echocardiogram Vs Stress Echo: Discerning The Differences
Cardiologists often order diagnostic tests to better understand the interworking of your heart. Understanding why the test was ordered along with proper test preparation are important to eliminate potential cancellation or rescheduling for patients. Two tests that are often misunderstood are the Echocardiogram and the Stress Echocardiogram .
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.
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What To Expect After Echocardiography
You usually can go back to your normal activities right after having echocardiography .
If you have a transesophageal echo , you may be watched for a few hours at the doctor’s office or hospital after the test. Your throat might be sore for a few hours after the test.
You also may not be able to drive for a short time after having TEE. Your doctor will let you know whether you need to arrange for a ride home.
What Is An Echocardiogram Stress Test
The purpose of the echocardiogram stress test is to determine if the clogging in my arteries is negatively impacting heart function. I was very impressed with the sophistication of the process as I lay there watching the computer screen with amazing interior images of my heart displayed clearly.
Nadiya Meriwether, a highly skilled registered cardiac sonographer, patiently talked me through the process while expertly taking a variety of measurements, like the size of each of my cardiac chambers, the diameter of major blood vessels, the degree of movement of heart walls to determine elasticity or stiffness, etc.
It was fascinating, and I felt like a kid in Disneyland, watching my heart valves open and close with each beat. It also made me appreciate the enormous complexity of the human body, and all the things that must be coordinated perfectly from moment to moment just to keep us alive.
Thankfully, at rest to this point in the test, it was all good news. Next, however, would be the real test of how well my heart functions under the extreme stress of intensive exercise. I mounted the treadmill under the watchful eye of Sadlo and began walking. The speed of walking and elevation was increased rapidly, and I was exhausted in 13 minutes, a pretty good score for my age indicating that Im highly fit. I dismounted and immediately the echocardiogram was repeated.
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Can Stress Test Detect Blockage
When arteries are blocked by 70% or more, stress tests can be used to detect them. Angina is a condition characterized by severe narrowing of the chest. The results of a stress test, however, do not rule out the possibility of a heart attack in the future. In addition, plaque ruptures, clots, and blocks arteries, so it is important to keep it out of the body.
What Abnormal Results Mean
An abnormal echocardiogram can mean many things. Some abnormalities are very minor and do not pose significant risks. Other abnormalities are signs of very serious heart disease that will require further evaluation by a specialist. Therefore, it is very important to discuss the results of your echocardiogram in depth with your health care provider.
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What Are The Risks Of A Dobutamine Stress Echocardiogram
Possible risks associated with a dobutamine stress echocardiogram include:
There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your healthcare provider before the test.
Certain factors or conditions may interfere with a DSE such as:
Smoking or using any other form of tobacco within 3 hours of the test
Ingesting caffeine within 3 hours of the test
Taking beta-blocking medicines these may make it hard to increase the heart rate to an appropriate level.
Sometimes The Two Tests Are Done Together
When we want to see images of your heart pumping after youve exercised, we do a stress echocardiogram, usually called a stress echo for short.
First, we do a regular echocardiogram to see images of your heart when youre at rest. Next, you go through the regular stress test by walking on the treadmill or riding the bike. Then you quickly return to the exam table so we can do another echocardiogram to see images of your heart when its beating faster after exertion.
At NJ Cardiovascular Institute, our team is equipped to diagnose and treat issues affecting heart health. Our cardiology services are available at two offices in Newark and Secaucus, New Jersey. Find out if you could benefit from heart testing by scheduling a consultation online or .
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What Is Echocardiography
Echocardiography , or echo, is a painless test that uses sound waves to create moving pictures of your heart. The pictures show the size and shape of your heart. They also show how well your heart’s chambers and valves are working.
Echo also can pinpoint areas of heart muscle that aren’t contracting well because of poor blood flow or injury from a previous heart attack. A type of echo called Doppler ultrasound shows how well blood flows through your heart’s chambers and valves.
Echo can detect possible blood clots inside the heart, fluid buildup in the pericardium , and problems with the aorta. The aorta is the main artery that carries oxygen-rich blood from your heart to your body.
Doctors also use echo to detect heart problems in infants and children.
What Is A Stress Test
In a , you walk on a treadmill that makes your heart work progressively harder. An electrocardiogram monitors your heart’s electrical rhythms. The doctor also measures your blood pressure and monitors whether you have symptoms like chest discomfort or fatigue. Abnormalities in blood pressure, heart rate, or ECG or worsening physical symptoms could point to coronary artery disease : fatty deposits that reduce the flow of oxygen-rich blood to the heart muscle.
If stress testing were 100% accurate, everyone would be having them regularly. But stress testing doesn’t accurately diagnose all cases of CAD, and sometimes it points to CAD in people who do not actually have the condition. “The test result is never, by itself, certain,” Dr. Bhatt says. “It can be used to move the probability up or down of there being coronary artery disease. It can’t absolutely rule it out or diagnose it.”
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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.
Why Might I Need A Dobutamine Stress Echocardiogram
Possible reasons for getting a dobutamine stress echocardiogram may include:
To assess the heart’s function and structures
To further assess the degree of known heart valve disease
To determine limits for safe exercise before you start a cardiac rehabilitation program or are recovering from a cardiac event, such as a heart attack or heart surgery
To evaluate the cardiac status before heart surgery
There may be other reasons for your doctor to recommend a DSE.
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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.
Is An Echocardiogram A Stress Test
Dobutamine stress echocardiograms are used to evaluate the hearts performance. echocardiograms are tests that measure the hearts structural and functional state. Stress echocardiograms are tests that measure how well the heart is able to withstand stress. Exercise on a treadmill or taking dobutamine, a medicine that reduces inflammation, can help you cope with stress.
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Dont Stress The Stress Test
If more information is needed, your doctor may ask for a cardiac stress test. Also called an exercise stress echocardiogram, the stress test is designed to monitor the hearts response to physical activity.
Unlike the traditional echocardiogram, this procedure typically requires you to be in a fasted state and refrain from taking certain medications on the day of the test. It is usually performed on a treadmill that gradually increases in both speeds and inclines until a target heart rate is reached or you experience symptoms that require you to stop. A baseline Echo is taken before the start of the stress test and again at the completion for comparison.
The stress test is done to evaluate for symptoms of possible coronary artery disease, or to evaluate the functional capacity and ability to raise your heart rate or rhythm, explains Dr. Alvarez, adding that there are alternatives to the treadmill test for those people who are unable to physically exercise. There is a pharmacological stress test, where we use medication to induce the heart response to exercise while the patient is seated in a chair that gives us the results we need.