Stress-echocardiography (stress-echo)

What is a stress-echocardiography?

Stress-echocardiography is an ultrasound examination and a sensitive method for the detection of circulatory disorders of the heart musculature. Constrictions of the coronary arteries (stenoses) lead to circulatory disorders of the heart muscle, which is then no longer adequately supplied with oxygen. In the worst case, this can result in a heart attack. There are various possibilities of detecting circulatory disorders of the heart muscle. The standard examination is the stress-ECG, in which the patient must exert himself physically. In the case of the dynamic stress-echocardiography, ultrasound examinations of the heart are carried out according to a specific procedural pattern, while the patient carries out the stress-ECG on a special stress-echo couch.
This method is however not possible for every patient.
In the case of pharmacological stress-echocardiography, the oxygen requirement of the heart is increased by means of medication. The muscles with lower blood circulation are not adequately supplied with oxygen, resulting in a wall movement disorder in this part of the muscle. These wall movement disorders are displayed by means of echocardiography, and enable conclusions to be drawn on the degree of severity of the underlying disease.

When is a stress-echocardiography necessary?

An abnormal movement of the heart muscle wall can occur earlier under stress, and thereby be identified earlier by means of stress-echocardiography then typical changes which might be registered for example by an ECG. Stress-echocardiography therefore enables the early and differentiated confirmation of circulatory disorders of the heart. This can significantly increase the probability of identifying such a disorder.

Procedure

The fast-acting medication which increases the oxygen requirement of the heart is injected into a vein in the arm. The heart is monitored by ultrasound before, during and after this injection. As with a rest-echo, the heart muscle, the heart valves and the blood flow in the heart are displayed and recorded with the aid of ultrasound and Doppler technology.
After the examination, the effect of the medication can be counteracted immediately by another medication.
The examination is carried out at our practice on an out-patient basis.

Duration

The examination can be completed after 15 minutes. The patient then remains under observation in the practice for half-an-hour to an hour.

Risks

The examination poses no risks. Complaints may nevertheless occur, such as heat sensations, palpitations, headaches and feelings of pressure in the chest.
Caution is indicated in the case of patients suffering from glaucoma or prostatic hyperplasia, of which the doctor should be notified in all cases.

Note

The patient should not drink any coffee, tea or cola, or eat any chocolate or bananas for 24 hours before the examination, since such foodstuffs can falsify the result. Certain medications, in particular ß-blockers, must not be taken in the evening or morning before the examination. Digitalis and blood pressure tablets are allowed following consultation. The patient should not eat or drink anything for four hours before the examination.

After the examination, the patient may eat again and resume taking their normal medication. Patients may also drive home using their own car.