Aa
A
A
A
Close
Heart Disease Forum
This expert forum is not accepting new questions. Please post your question in one of our medical support communities.
Avatar universal

Stress Echo

How is a stress echocardiogram done?  Are medications used?  If so, what type are coming used?
29 Responses
Avatar universal
DottyCece,

Thanks for the question, but you better be careful ... asking 2 questions on the same day will often lead to harsh responses from the other readers.

There are 2 basic types of stress echo tests: exercise and pharmacologic (medication-based).

Both tests start with the echo tech obtaining a resting echo.  With an exercise echo, the patient will then get on a treadmill or bike and exercise to peak capacity.  Immediately after exercise cessation, the person moves back to the echo bed, and a second echo is done while the heart is still beating rapidly.  The two echo image sets are analyzed for differences in wall motion, valve regurgitation, pulmonary pressures, etc.

Pharmacologic echo stress tests are performed most often with dobutamine as the agent used to increase the heart rate and contractility.  Some European centers use adenosine instead.  Again, a resting echo is obtained.  The dobutamine is then infused while the person remains recumbent. The echo tech takes serial pictures as the heart rate increases. The two echo image sets are analyzed for differences in wall motion, valve regurgitation, pulmonary pressures, etc.

In general, if a person can exercise, then we recommend that that is the method used for the "stress".

Hope that helps.
Avatar universal
Mine was done without meds, on a treadmill.  They did a resting echo first, then put me on the treadmill & at the point I had to stop I had only a few seconds to get back on the table for a repeat echo.  They then compared the resting echo to the one done immediately after the exercise.

Good luck.
Avatar universal
Dottycece

Two questions posted in a day - Thats very fortunate!

This site has a very good search facility which can be helpful for providing insight into conditions, precedures etc.  You'll probably get more detail from browsing the archives then you will from the doctors reply.

Best Regards

Sq
Avatar universal
Yeah, two questions in one day, and three total for the week.  That's very fortunate for you, but what about the rest of the whole wide world?  You do realize that if you post a question that NO ONE ELSE CAN??  I had already requested that the administration of this board limit posters to just one per month, but you are incredible.  The above poster was being nice about it, but I can't...so selfish.
Avatar universal
Wow

You folks are really MEAN!!  So what if there were two questions posted?  If the opportunity presents and this person has legitimate questions, we can all benefit from these answers.  I have been following this site for a long time and find a few people always responding.   I have never noticed such anger to people like Hankstar or whatever his name is.  BE KIND!! or this site looses all credibility.  Life is too short to deny someone some compassion.  Perhaps this person is seeking some answers for a very difficult burden.  Let us all be kind.
Avatar universal
Hey mmfd, relax.  You don't even know if this person knew that there was a limit for posting.  I agree that given the system that people should be limited to one per day, but without that, how can it be expected that everyone will know?  It's not like this on all the forums of this site.
Avatar universal
For the record:

I DID NOT KNOW THERE WAS LIMIT TO QUESTIONS.  I forgot to include the second question withe the first and it did not appear any different that those who ask 5-6 questions in one post.

I have to make some very tough decisions in a very tough health situation that I find myself.  I will be spending thousands and thousands of dollars at Cleveland Clinics because my insurance will not give me a referral to CC since they think we have similar specialists in our network.  So, I feel therefore that I do have a right and responsibility to get as informed as possible and where better than where I am spending my money?????  So mmfd, so sorry you didn't get to ask your question.  I merely click on and if I can post I will post a question if I truly am seeking an answer instead of just pontificating... None of us are experts. We are all seeking solutions to very serious problems.  I just hope there would be a degree of compassion and caring for others.  I feel very badly that someone would be so nasty to me.  I am so depressed already and this just adds to it all.

I WILL NOT ACCESS THIS SITE ANYMORE OR EVEN FOLLOW THE CONVERSATIONS.  I AM GETTING SICK OF ALL THESE MINOR PALPITATION QUESTIONS.  FOR THE RECORD, THOSE ARE NOT A MAJOR THREAT TO ONE'S HEALTH AND ARE MOST OFTEN VERY NORMAL.  i HAVE LIVED WITH A WHOLE LOT OF THEM FOR OVER THIRTY YEARS..JUST GET ONE WITH IT AND COPE.  IT IS NORMAL11  

SO GOOD BYE EVERYONE. I WON'T BE BOTHERING ANY OF YOU ANYMORE.  I HOEP MMFD IS ABLE TO POST AS OFTEN AS SHE OR HE HAS A DECENT QUESTION THAT OTHERS CAN BENEFIT.

I can't believe how upset this has made me and I am sorry about that.  I am at the end of my coping ability!!!!!
Avatar universal
So Sorry that I violated some rule I knew nothing about.  I will be seeking a consult from Dr. P. McCarthy at CC and will be paying for it in cash since my insurance company will not give me a referral.  So, I do think I have the right to get as much information from you, a representative of CC to whom I will be paying thousands of dollars.  But, to avoid angering others, I will no longer be using or accessing this site.  I do not appreciate the way I was communicated with but I want you to know that your responses have been very helpful to me.  I have tough decisions to make in a tough situation and truly wouldn't want to wish this situation on anyone.

Thanks for your help.
Avatar universal
So Sorry that I violated some rule I knew nothing about.  I will be seeking a consult from Dr. P. McCarthy at CC and will be paying for it in cash since my insurance company will not give me a referral.  So, I do think I have the right to get as much information from you, a representative of CC to whom I will be paying thousands of dollars.  But, to avoid angering others, I will no longer be using or accessing this site.  I do not appreciate the way I was communicated with but I want you to know that your responses have been very helpful to me.  I have tough decisions to make in a tough situation and truly wouldn't want to wish this situation on anyone.

Thanks for your help.
Avatar universal
I am glad that this question was posted because I am having a stress-echo done soon myself.  This question addressed my concerns as well.
Avatar universal
I for one dont care who posts or how often.  I think each and every question has merit to it and someone else, other than the poster, who reads this forum more often than not benefits from the questions because a lot of us have the same issues.
But Dotty, for u to say that u r tired of hearing about us with "minor" palpitations posting questions, is really unfair.  what may seem "minor" to u certainly is not minor to the people who experience the palpitations.  that was really an insensitive thing to say, in my opinion.
Pan
21064 tn?1309312333
Hi fellow posters,

It seems quite probable that if one person has a question, at least one other person on this forum has the same question. This isn't the first time that forum readers have lashed out at at one another for "frequent" posting. It is a shame that some of our readers have decided not to visit or post anymore. No doubt, we each arrive here looking for answers to our own set of "symptoms".  Yet, it doesn't take long to become a part of the forum "family"; we are a group who share a common interest and look out for one another. Certainly, the doctors have answered each of our questions many, many times over the years. Yet, each time, their responses are thoughtful and considerate.  

There are so many people who do not have the luxury of choosing the CCF for their cardiac care, and this forum provides them with a unique way of gathering a little information and perhaps, a little reassurance from a world renowned heart center!! Life is short and we are so fortunate to have the opportunity to ask ANY questions. Take the opportunity to learn from what is discussed, and remember if you are that concerned over your own medical care, it is always best to get in touch with your own doctor or go to the emergency room.  Please....If we are not careful, no one will be asking a question.
Avatar universal
I had a stress echo test & it was "normal," except it took 17 minutes for my heart rate to go from 181 peak down to 110 (though my baseline resting heart rate before the test was 88).  In addition, the blood pressure readings seemed a bit odd:
Rest 100/74
3 minutes  140/80
6 minutes 140/70
7 minute--peak exertion
recovery 1 minute 128/50
2 minutes 122/70
3 minutes 136/70
no further blood pressure readings
Just curious about the significance (if any) of these details.
Aloha,
Starion
Avatar universal
I was surprised at the comments and rudeness of some of you.  Where is the rule about posting?  I looked and cannot find it.  I agree that palpitations are minor in comparison to many other problems.  Some people obssess about these and get very anxious for no legitimate reason whatsoever. Those need to learn to adjust. I think palpitations should always be address to rule out any real problems.  They are often just normal and yes they feel funny.  Could we all be kind, courteous and I agree compassionate?  Life is fragile and very short.  This site should be a support.
Avatar universal
I have to say that once again, I agree with Hank.  Most of the participants of this forum are friendly, polite people.  Unfortunately, sometimes we read things on this forum that these same people say in anonymity that they would never say in person.  Thankfully, this is infrequent, but remembering that some of the people posting questions are quite scared or troubled might help us all to reconsider our poisonous words.  

Two questions per day are answered because that is all this site can afford in terms of bandwith from the ISP.  The doctors are certainly willing to answer more questions, and frequently we do if the questions are posed in the comment section (and seen by us!).

I am certainly amazed every day by the participants willingness to listen and help.  If someone on this forum is out-of-line, it's incumbent on us to treat that person in the same way that we would wish to be treated.

Thanks.
Avatar universal
Sorry to everyone that I offended but I stand by my response.  I was direct but not rude.  The people who keep taking the opportunity away from others are rude, IMHO!
Did anyone notice that the physician himself even mentioned the multiple questions?

As for not knowing there is a limit on questions, see the recent VERY lengthy discussion on this very topic.  DEC. 29! In addition, when one sees that only 2 questions are posted each day, then one might  be able to glean from that, that there is  a limit!

Hankstar, I am certainly not cruising this site looking to criticize people.  I am here because of the golden opportunity we have to ask questions from a real doc from a well known heart center, just like you.  By the way, I do value your responses and know that you do have a lot to offer.  I do plan on visiting the site often to read the MD answers.
Avatar universal
I just want to say thanks to the docs from CC, the site owner as well as all the caring posters.

This site has made my own "less-than-desirable" situation a lot more realistic, less fearful and something to occasionally laugh at - for which I am grateful.  I also realize how well off I am compared to many, and for that I am also grateful.

Have a nice weekend.
Avatar universal
Hi there
I'm a little amazed at this bit of bother.  I've read this forum for ages now and I've often known people write in with 4 or 5 questions in their post which the cardio ofen replies on the lines of
1. Answer
2. Answer
3. Answer
4. Answer
I've actually never known the cardio comment about the number of questions in a post before.  I'm sure I myself have asked more than one question in my posts.
Good luck to you, Dotty Cee.
Best Wishes, Linda
Avatar universal
To everyone who has suffered with palpitations, benign, minor, severe, asymptomatic, symptomatic, anxiety induced, stress induced, no structural defect, structural defect etc..etc..THEY are real to each and everyone one of us and NO Question is less important if you do not know the answer!! Dotty continue to post when you can and use this forum as a source of research...clearly being able to post a question is luck of the draw everytime... and I am glad  for you luck was on your side, hope you were able to find comfort and obtain further knowledge about your situation...Best Wishes........I have been a nurse for 22 years and work on a cardio/pulmonary unit and have seen first hand hundreds of patients trying to cope with fear of the unknown...from a range of homeless people to multi-million dollar CEO's.....yet they are all the same on a hospital unit wearing a johnny coat.....HUMAN....and everyone deserves respect and compassion.
21064 tn?1309312333
Hankstar, I remember when you and a few other were "slammed" for posting "too many questions"...OUCH!! Like you, I can appreciate why some folks might be a little annoyed, but there are just as many others who are breathing a sigh of relief when someone asked "their" very question. The anonymity that the boards provide is great for people who may find it difficult to ask questions in a different setting. But, unfortunately, it also provides an opportunity for people to say things they otherwise might keep to themselves.

When I mentioned about "no one" posting, I was referring to us loosing the boards altogether. I was concerned that the doctors and administators would become so annoyed at the "slams" and degrading remarks that they would consider shutting down the forum. I sure hope that doesn't happen. I know that I have learned a great deal from everyone here, and I remain profoundly grateful to Dr. RCJ for his concern and thoroughness when I posted my questions last year.

I've also noticed that quite a few regulars have stopped frequenting the site, and I feel bad about that. We each have something to offer and the forum works best when we all share ideas and listen to one another. Hank, I'm glad you toughed it out and decided to stay!! By the way, it is about 10 degrees in Cleveland!! Send us some sunshine :)

Connie
Avatar universal
It is unfortunate that this has happened.  Let us all just agree to be respectful, considerate and kind.  The lesson in this is we should not jump to conclusions but, instead, validate our perceptions in a tactful and respectful manner.  When we are ill, it is very natural to be focused on one's self and not really sensitive to others.  It is helpful to recognize that and try to take this into account as we communicate and interact with others.  I do not want to appear as "preaching".  This is how I view all of this so let us continue to help and support each other.  Looks like Dotty is gone and that is too bad but we can all work to make sure that does not happen again.
Avatar universal
Actually, the protocol is DESIGNED so you reach your peak heart rate in 7 minutes; my heart rate was 181 bpm (10 METS, incline 14%, 3.4mph) at peak & the docs said my exercise tolerance was good.  Neither I nor any of my docs believe I am at all deconditioned & I have never smoked.  I have idiopathic emphysema but no limitations on my exercise & my pulmonologist says I walk at twice as fast as a "normal" person.  I am considered in excellent physical condition, so I puzzle my cardiologist, since I do not have problems with oxygen saturation during exertion either.  He has ordered an echo next week & also another holter withholding my lung meds that may be responsible for my tachycardia.  My pulmos have agreed, providing I can take rescue meds as needed.

Thanks for your insights.  I really appreciate all your thoughtful comments & help.  You & many of the others & the great Cleveland Clinic docs really help SO MANY of us!  

I am saddened to see folks turn on one another here--I've seen it on some of the lung forums & boards as well.  Sure wish folks would try for more understanding and tolerance, since we're all in this together & we're all trying to help one another & optimize our health.
Avatar universal
Dear Hankstar & Everyone,
Received an e-mail from my cardiologist today.  He's conferred with my internist & the electrophysiologist in his practice.  They all agree I MAY have IST (inappropriate sinus tachycardia).  The repeat holter without my lung meds should be helpful in sorting out the diagnoses (both lung docs have approved); we'll schedule it after we discuss the results of my upcoming echocardiogram.
Thanks for your thoughts on this.  Appreciate it.
Aloha,
Starion
21064 tn?1309312333
Wishing you luck on your upcoming tests!  We will be thinking of you. Maybe your doctor is on to something here.  Buena suerte!

Didn't find the answer you were looking for?
Ask a question
Popular Resources
Is a low-fat diet really that heart healthy after all? James D. Nicolantonio, PharmD, urges us to reconsider decades-long dietary guidelines.
Can depression and anxiety cause heart disease? Get the facts in this Missouri Medicine report.
Fish oil, folic acid, vitamin C. Find out if these supplements are heart-healthy or overhyped.
Learn what happens before, during and after a heart attack occurs.
What are the pros and cons of taking fish oil for heart health? Find out in this article from Missouri Medicine.
How to lower your heart attack risk.