This is an exercise test that uses ultrasound to determine if the heart is not getting enough blood with exercise. The test uses sound waves to obtain moving pictures of the heart. A machine generates these sound waves, called ultrasound, and then listens for the return of these sounds as they bounce back from the walls and valves of the heart, in the same way you would listen for an echo bouncing back to your ears from a distant cliff. The machine interprets the sounds to create a picture of your heart on a monitor. These pictures are recorded onto videotape or into a computer. These pictures of the heart are obtained at rest and after you have exercised on a treadmill machine.
Electrical wires, called electrodes, are painlessly stuck onto your skin. You will then lie on your side or back and a sound producing probe is put on different parts of your chest to allow a specially trained technician to obtain pictures of your heart. This is usually painless but can be uncomfortable for the occasional person with chest tenderness. Please let us know before the test if your chest is sensitive to touch or if you are having discomfort at any time during the procedure or if you are unable to assume certain positions. If your heart is not well seen, it may be necessary to start an IV and inject a special echo contrast agent. After the resting pictures are obtained, you will be asked to walk on an treadmill exercise machine. At first, you will walk slowly, but every few minutes, the speed and slope of the treadmill will be increased. You will be monitored closely for your heart rate and rhythm and symptoms. You can ask to stop the machine anytime, but if you are comfortable, you will be encouraged to exercise as well as you can. When you are exercising as hard as you can, the treadmill will be stopped and you will be quickly guided back to a bed so that ultrasound pictures of your heart can be obtained again.
The test will show size and function of your heart at rest and immediately after exercise. Normally the heart beats stronger with exercise. If part of your heart lacks blood or is weakened for other reasons, then exercise may cause that part of the heart muscle to pump or contract less strongly than other parts of the heart that are receiving enough blood. This change in heart function can be seen by comparing the pictures of your heart at rest and with exercise. Changes in your electrocardiogram and heart rhythm will also be recorded and noted by the cardiologist.
Please bring a list of your medications and bathe prior to the test as you will need to completely disrobe from the waist up. With the exception of deodorant, please do not apply lotions, oils, powder, or perfumes after bathing. A hospital gown will be provided for women or as needed. Please wear exercise clothing and walking shoes, preferably with rubber soles. You can normally expect to be short of breath and to sweat with exercise. It is also advisable to go to the restroom just before the test so you are not distracted by this need during the test. Fasting is required 3 hours prior to the test, though medications can be taken with sips of water. You will be able to rest for 5 to 10 minutes after exercise. No special recovery is otherwise needed, though you may be tired.