Stress echocardiogram
Information for patients from Cardiology
Your doctor has referred you to the hospital for a stress echocardiogram. This leaflet will explain the following.
What a stress echocardiogram is.
How you prepare for the procedure.
What will happen when you arrive for the procedure.
What the different stress echo tests are.
How you may feel after the test.
We hope this leaflet answers some of the questions you may have. If you have any further questions or concerns, please speak to a member of your healthcare team.
What is an echocardiogram (echo)?
An echocardiogram (echo) is a test that uses sound waves to build a moving picture of your heart. Similar to an ultrasound that you would have if you were pregnant.
There are different types of echo scans that have specific elements to them, such as:
a Dobutamine (stress) echo, which is an echo combined with a drug infusion; and
an exercise (stress) echo, which is an echo combined with exercise on a bike.
What is a stress echocardiogram?
A stress echo is an ultrasound scan of your heart. The scan is done while your heart rate is increased, either by exercise or medicine. The purpose of the test is to assess how your heart responds to exercise / medicine. The test can help your doctor see if the following applies to you.
Your symptoms are due to underlying heart disease.
Your heart would work better if you had surgery.
There is a problem with one of your heart valves.
Your heart rate will be increased to a level, which is calculated based on your age.
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There are two ways to perform this test. Before your test begins, your doctor will explain which test you are having and why. You will only have one type of stress echo.
Exercise Stress Echo (ESE) – exercising using a supine bike.
Dobutamine Stress Echo (DSE) - infusing a medicine named Dobutamine through a cannula. This simulates exercise, increasing your heart rate.
If you have any health problems that may limit your ability to ride a bike, please let us know when booking your appointment. Health problems can include:
knee, hip or back issues; or
any general health conditions that do not allow you to exercise for 8 to 10 minutes.
If you cannot ride the supine bike, we will book you for a Dobutamine stress echo instead.
What happens if I choose not to have the test? Are there any alternatives?
If you prefer not to have this test, we will refer you back to your referring doctor. They can consider and discuss with you having one of the following tests instead.
Nuclear scan.
Cardiac MRI with stress perfusion.
CT coronary angiogram or invasive coronary angiogram.
How do I prepare for my test?
If you take any of the medicines listed below, stop taking them 2 days before your test. Do not take them again until after your test.
Atenolol
Bisoprolol
Carvedilol
Nebivolol
Propranolol Hydrochloride
Sotalol hydrochloride
Metoprolol tartrate
Diltiazem
Verapamil
Ivabradine
These medicines slow your heart rate. If you continue to take them, they may make it harder to raise your heart rate during the test. This can affect the results of your test.
If you have been diagnosed with Atrial Fibrillation (AF) and are taking any of the above medicines to control your heart rate, please tell us when booking your appointment. We will advise you whether:
you can continue taking the medication before your test; or
you need to change the dosage.
Please continue taking your other medications as usual before your appointment. Please bring all your medications in their boxes or a list of your prescriptions.
You must eat and drink as normal, there is no need to fast for this test. Try to eat at least 1 hour before the test. You must be well hydrated when attending for the test. Make sure you drink plenty of water.
If you are coming for an exercise stress echo, please wear trainer shoes and sensible dress.
What happens when I arrive for my procedure?
When you arrive, you will be seen by a team that will include one or more of the following:
a doctor
a physiologist, and
a nurse.
If you are having a Dobutamine stress echo, you will be asked to sign a consent form.
We will insert a cannula into a vein in your arm to administer the contrast / medicine. If we need to use contrast, this will be explained to you before your test. If you have any questions or concerns, please speak to a member of the team.
If needed, Sonovue contrast dye will be used for the test. Contrast will help us get clearer images of your heart. This will help us to give a more accurate diagnosis. This is a contrast / dye specifically used for ultrasound. If you have had an allergic reaction to different types of contrast (such as x-ray contrast), this does not mean you will be allergic to Sonovue contrast.
What are the different tests?
Exercise stress
We will ask you to remove all clothing from the waist up, and lie back on the bike. We will give you a hospital gown to wear with the front open. This is so we can track your heart's activity.
If needed, you will be given contrast through the cannula.
We will place sticky patches (electrodes) to your chest, which are connected to the echo machine. This first test is called a resting echo, so we can see what your heart is doing when you are resting.
After the resting echo, you be asked to exercise using the supine bike. When you have finished exercising, we will repeat the echo.
The test should not be uncomfortable. You may feel mild symptoms, such as:
palpitations (a feeling of strong and fast heart rate); or
feeling dizzy or sick.
This is normal, but please tell the team if you have any of these symptoms.
Dobutamine stress
Dobutamine has a similar effect to exercise on the heart and circulation. It increases your heart rate and the strength of its contractions without exercising.
We will ask you to remove all clothing from the waist up, and lie back on the bed. A resting echo will be performed while you rest on the bed on your left side.
Dobutamine infusion is then given through the cannula in your vein. The infusion will gradually increase your heart rate. We may have to use additional medicines (such as Atropine) to increase your heart rate further, to achieve the target heart rate.
A series of echo images will be taken during the infusion.
The test may end early if you:
experience any adverse symptoms during the test, such as an abnormal heart rhythm or low blood pressure; or
your doctor sees any problems on the ultrasound scan.
The investigation should not be uncomfortable. You may feel mild symptoms, such as:
palpitations (a feeling of strong and fast heart rate); or
feeling dizzy or sick.
This is normal, but please tell the team if you have any of these symptoms.
The test can take 45 to 60 minutes.
What are the benefits to having these tests?
These tests allow us to assess any significant blockages in the coronary arteries.
The tests assess the significance of valve disease and problems with the heart's pumping function.
What are the risks?
A very rare risk is a severe allergic reaction to the contrast agent. This happens to 1 in every 10,000 patients.
There is also a rare risk of abnormal heart rhythms and heart attack.
Any reactions or complications will happen during the test.
How will I feel after the test?
You may feel tired after your test. This is normal. Bring someone with you to your appointment, who can drive you home afterwards.
You must arrange for someone to drive you back home if you are having a Dobutamine stress echo. If not, you will be asked to wait in the department for 1 to 2 hours. This allows for the effect of the drug to clear from your body.
When you can return to work and normal activities depends on the patient. Some patients feel fine after their test, but others may need to rest for the remainder of the day.
If you did not have any of the symptoms listed above during your test, you can go home after the test.
Your results will be sent to the doctor who referred you for the test.
What if I have any questions or concerns?
If you have any questions or concerns, please contact the Complex Echo Co-ordinator on 01843 234394.
If you have any concerns at home, contact your GP or 111.
Further information
References
[Web sites last accessed 3 March 2026]
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