Stress echocardiography

Stress echocardiography is a modern, non-invasive method for assessing heart health that allows evaluation of heart function under physical stress. This examination helps diagnose various heart conditions, such as coronary artery disease, and assesses the heart muscle’s ability to respond to exertion.

Medication-induced stress echocardiography.

During medication-induced stress echocardiography, medications are used to artificially increase the heart rate and workload, similar to what occurs during physical exercise. This method is suitable for patients who are unable to perform physical activity due to health reasons but still require an assessment of heart function. The medications stimulate the heart, allowing important information about its condition to be obtained.

Stress echocardiography (Ergoline).

Stress echocardiography is performed while the patient engages in physical exertion on a specialized stationary bike. This method is suitable for patients who are able to perform physical activity. During the echocardiography, the heart’s response to exercise is monitored, and any abnormalities or deviations that may indicate possible pathology are assessed.

Why is stress echocardiography performed?

Stress echocardiography is performed to determine whether any part of the heart is receiving reduced blood supply, which may be related to artery spasm or narrowing/blockage in one of the coronary arteries.

Preparation for the examination:

On the day of the test, do not eat or drink for at least 2 hours before the stress echocardiography. Avoid alcohol consumption for 24 hours prior to the test, as well as intense physical activities such as running, fast cycling, weightlifting, and similar exercises. Also, avoid caffeine and other stimulant-containing drinks or substances.

Bring light and comfortable sportswear and non-slip shoes suitable for exercise.

Beta blockers (e.g., Metoprolol, Bisoprolol, Betaxolol) should be discontinued 2 days before the procedure. Other regularly used medications should only be taken according to your doctor’s instructions, which will be discussed during the consultation before scheduling the stress echocardiography.

There is a possibility you may feel weak after the examination, so it is advisable to have someone accompany you to take you home.

Important information to tell your doctor:

• Whether you are breastfeeding, pregnant, or suspect you might be pregnant;
• If you have any addictions to medications, substances, or alcohol;
• Any current or past medical conditions;
• What medications and drugs you are taking;
• Any allergies or intolerances of any kind, including their side effects.

On the day of the examination:

You must arrive fasting – do not eat or drink for two hours before the test. Smoking and consumption of stimulant beverages are prohibited.

If you feel unwell or are ill, it is your responsibility to notify the administration at +371 26 115 549 to cancel your appointment no later than 2 hours before the examination. Please arrive at the center at your scheduled appointment time.

Before proceeding to the diagnostic department, you will read and sign the “Patient Consent for the Medical Procedure ‘Stress Echocardiography’.”

Your belongings will be securely stored in a locked cabinet during the procedure. Prior to the test, please use the restroom and change into sportswear.

How the test is performed:

1. Before the test, your blood pressure will be measured at rest, an electrocardiogram (ECG) will be recorded, and a resting echocardiogram will be performed while you lie on your left side.
2. Electrodes will be attached to your chest and back to monitor your heart rate and rhythm. A blood pressure cuff will be placed on your upper arm, and a pulse oximeter will be attached to your finger to measure oxygen saturation in your blood.
3. After the resting measurements are completed, you will sit on a stationary bike and begin physical activity according to the doctor’s instructions.
4. The test will be stopped once the target heart rate is reached or earlier if you experience chest pain, shortness of breath, or any other symptoms that make continuing the test difficult.
5. During the test, to reach maximum workload, the doctor may administer intravenous medications to stimulate your heart. In this case, an intravenous catheter will be inserted. After the medication is given, you may feel your heart beating faster and an increase in blood pressure similar to normal physical exertion.
6. After the exercise, a repeat echocardiogram will be performed.
7. If necessary, intravenous beta blockers and/or other medications may be administered to reduce blood pressure and heart rate.

After the test:

After the procedure, you will remain in the clinic for observation if medications were used to stimulate your heart. Once your vital signs have stabilized, the intravenous catheter will be removed. You will be allowed to go home only with permission from the medical staff. You may resume eating and drinking and carry out your daily activities, except for strenuous physical exercise.

Risks and complications.

Stress echocardiography is performed under the supervision of trained medical personnel and is generally safe, but like any procedure, it can have unpredictable side effects, risks, and consequences:

• Pain, discomfort, and bruising around the intravenous catheter insertion site;
• Chest pain, nausea, weakness, tremors, headaches;
• Elevated blood pressure, dizziness, heart rhythm changes;
• Difficulty breathing;
• The test may not be completed due to medical reasons (e.g., life-threatening heart rhythm disturbances) and/or technical reasons;
• Anaphylactic reaction to medications or drugs used during the test;
• Heart rhythm and respiratory disturbances after the procedure;
• Myocardial infarction (heart attack);
• Intracranial bleeding;
• After blood pressure lowering medications, low blood pressure, fatigue, rashes may occur;
• Exacerbation of existing diseases/conditions, etc.;
• In rare cases, cardiac arrest and respiratory arrest can occur during the test.

If you have any questions or uncertainties regarding the potential complications mentioned above during the examination, the doctor will provide a detailed explanation addressing all unclear issues and/or medical terminology.