How is the heart test carried out

Stress echocardiography (stress echo)

Stress echocardiography - also called stress echo - is an examination of the heart using ultrasound (echocardiography) at rest and under stress. After a Dysfunction of the heart muscle, which is based on poor blood flow to the heart muscle under stress.

The increase in heart rate is achieved in the context of a stress echo either through cycling or the administration of a drug.

Background information

The heart needs more oxygen during exercise. To do this, the heart rate and thus the blood flow through the coronary arteries, which supply the heart muscle with blood, are increased. With a narrowing of the coronary arteries it comes to a insufficient supply of the heart muscle with blood, which cannot always be detected in the stress ECG.

Possible uses

First and foremost, stress echocardiography is used in the case of inconsistent findings in the stress ECG, if coronary heart disease is still suspected with a normal stress ECG and to assess the importance of constrictions in patients with coronary heart disease.

The stress echo can also be used to assess the significance of aortic valve stenosis under stress and to check the vitality of the heart muscle.

Exclusion of use

Stress echocardiography should not be performed if there is acute cardiac pain, acute pulmonary embolism, or acute cardiac insufficiency. In the case of more severe heart valve defects and certain heart diseases, the stress echo occurs only under special conditions.

Preparation for stress echocardiography

Basically, the patient does not need to take any special precautions in front of a stress echo. He should in particular not sober but rather have had a small meal before the stress echo.

It makes sense when the stress echo sturdy shoes or possibly even sportswear (with bike load) to be carried. You should also bring a towel and utensils to freshen up.

Stress echocardiography using medication (see below) can be uncomfortable. The effect of the medication (rapid pulse) may still be noticeable some time after the stress echo (possible impairment of driving ability).

Complication and Risks of Stress Echo

A complication rarely occurs with stress echocardiography. The rate of more serious complications such as cardiac arrhythmias or a heart attack is slightly higher than with a normal stress ECG.

Procedure for a stress echocardiography

The stress echo is carried out in two different ways:

  • Stress echocardiography using medication: Here the heart rate is accelerated with the help of substances similar to stress hormones.
  • Stress echocardiography using Bike load: Similar to a bicycle ergometer, the load takes place in a semi-recumbent, laterally tilted position.

Echocardiography is performed during exercise. The modern devices allow a direct, partly 3-dimensional and computer-aided comparison of the heart wall movement between rest and stress.

Conclusion on stress echocardiography

The stress echo is a helpful, non-invasive examination method for Assessment of cardiac function under stress. The stress echo is mainly used in patients with an ambiguous stress ECG and to assess the importance of constrictions (stenoses) in coronary heart disease.

Dr. med. Harald Schwacke