Kaiser Permanente San Jose Cardiology Services

Exercise stress test

Echocardiogram

Exercise stress echocardiogram

Dobutamine stress echocardiogram

Transesophageal echocardiogram

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Exercise Stress Test

The exercise stress test is a type of electrocardiogram that measures the electrical activity of the heart while the patient is walking on a treadmill or riding an exercise bike. The test usually takes 30-45 minutes, including about 10 minutes of exercise (to the point of exhaustion). The exercise stress test helps detect heart conditions that may not be present when the body is at rest. The test can help determine if further testing is necessary because of possible coronary artery disease. It is also used to see if the heart is receiving adequate blood flow as activity levels increase and to determine if a cardiac treatment plan has been effective. Heart rate and blood pressure are monitored during the entire test. Patients should wear comfortable walking or athletic shoes and comfortable loose-fitting clothing.

Echocardiogram

An echocardiogram takes sound-wave images of the heart. A lubricating gel may be applied to the chest. Then a hand-held plastic ultrasound wand is pressed against the chest over the heart and moved through the gel. The probe sends and receives sound waves that then form an image of the heart on a computer screen. No preparation by the patient is required. The test does not cause pain, although there is a slight pressure on the outside of the chest from the wand. Sometimes the wand or lubricating gel may feel cold initially. There are no side effects from the procedure, which takes about 30 minutes.

The echocardiogram shows the four chambers of heart, heart valve disease, the strength of the heart muscle, congenital heart disease (present from birth), the presence of fluid around the heart and information about the pressures within the heart.

Exercise Stress Echocardiogram

This test is an echocardiogram performed while the heart is being stressed by exercise, such as walking on a treadmill. High-frequency sound waves from a hand-held wand provides images on a computer screen of the heart's valves and chambers as well as its movement during a heartbeat. The results are compared to a resting echocardiogram. Sometimes the procedure is combined with a special kind of ultrasound to monitor blood flow through the heart's valves.

Dobutamine Stress Echocardiogram

An echocardiogram takes sound-wave images of the heart. Sometimes the drug dobutamine is injected through an IV before the procedure to increase the contraction of the heart. Prior to the echocardiogram itself, a lubricating gel may be applied to the chest. Then a hand-held plastic ultrasound wand is pressed against the chest over the heart and moved through the gel. The wand sends and receives sound waves that then form an image of the heart on a computer screen. Avoid eating or drinking anything except water for four hours before the test. The test does not cause pain, although the heart rate rises due to the dobutamine. Sometimes the wand or the lubricating gel may feel cold initially.

The echocardiogram shows the four chambers of heart, heart valve disease, the strength of the heart muscle, congenital heart disease (present from birth), the presence of fluid around the heart and information about the pressures within the heart.

Transesophageal Echocardiogram (TEE)

This type of echocardiogram is used only in special cases. It allows the heart's structure, valves and blood flow to be better visualized than with a standard echocardiogram. A long, flexible transducer probe is threaded through the mouth into the esophagus where it is lined up with the heart. The transducer sends and receives sound waves that bounce off the heart structure and are viewed as an image on a computer screen. Before the procedure, an IV will be inserted into a vein in the hand or arm and the throat will be numbed with an anesthetic spray. The patient remains awake during the procedure, but medication will be injected into the IV to help him or her relax. The patient may be connected to an electrocardiogram machine during the procedure.

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