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A stress echo helps your doctor understand how your heart copes when it is made to work harder, such as during exercise. It can help to see if symptoms are due to underlying heart disease (such as angina or breathlessness) or assess the severity of established heart disease.

You will be asked to remove your clothes from the waist up, put on a hospital gown and leave it open at the front. We attach special stickers (electrodes) to your chest so that we can monitor your heart.

The stickers are connected to the echo machine by thin wires.

You will lie on a couch on your left side. A doctor and a physiologist are with you when you have the scan. We take the first echo, called a resting echo while you are on the couch. We then take the second echo when your heart rate is increasing. Your heart rate is monitored during the entire test.

A stress echo takes about 45-60 minutes to complete.

The test takes place in a room that is darker than usual so we can see the scan pictures on the screen better.

If you have the dobutamine injection during the test:

• You may notice your heart beating harder and faster, like when you are exercising. You may feel warm.
• We stop the injection once your heart is working hard enough.
• We continue to monitor your heart until the effects of the medicine have disappeared. This usually takes only a few minutes.
• You may feel slightly sick or dizzy from the injection, but this goes away quickly after we stop the injection.
• Please let the doctor know of any other side effects, or discomfort, you experience during the test. They will take care of any side effects, if needed.

• Medicine
  • Unless instructed otherwise by your doctor, it is important that you stop taking any rate controlling medication such as beta-blockers (atenolol, bisoprolol, metoprolol, propranolol, nebivolol and carvedilol), calcium-channel blockers (diltiazem and verapamil), or the angina drug ivabradine, 48 hours before the test.
  • These drugs prevent the stress medicine from making your heart work harder. If you continue taking these medications in the 48 hours before the test, your stress echo may need to be moved to a later date.
  • If your doctor wishes you to remain on these drugs for the test, you will be informed. 
  • You should continue taking all your other medication as prescribed by your doctor. If you have any questions about your medication, please contact your doctor, or the echo department on 020 375 82069.
• Caffeine
  • You should not have any caffeine products 24 hours before your examination as they may interfere with your test – this includes tea, coffee, green tea, cola, and energy drinks. Caffeine can also be found in both hot chocolate drinks and chocolate bars. 

All medical procedures carry some risk. It is important to remember that we would not recommend any procedure if we did not believe the benefits outweigh any risk. The risks will be different for each patient, so we will discuss the risks that apply to you in more detail before the procedure.

A stress echo is very safe, but there are some risks you need to be aware of:

• The heart may develop an abnormal rhythm in 0.1 per cent of patients (one in 1,000) having this test. This usually settles down without the need for any treatment. If treatment is needed, administration of a drug or a short electrical impulse to the relevant area restores the heart’s normal rhythm.
• A bad angina attack or heart attack may happen in less than 0.05 per cent of patients (one in 2,000) during the test.
• The medicines used may cause an allergic reaction in less than 0.01 per cent of patients (one in 10,000) during the test. If you have had allergic reactions to any medicine before, please tell your doctor before the test.