An exercise echocardiogram is also called an exercise echo or
stress echo. It’s a noninvasive test. It shows how well your heart is working d
during stress or exercise. It gives your healthcare provider information about how
well your heart pumps, how well your valves work, and it helps diagnose disease in
the arteries of your heart.
For the procedure, you’ll first have an echocardiogram to see how
your heart works at rest. A small handheld device called a transducer is placed on
your chest at certain places and angles. The transducer sends out high-frequency
sound waves. The waves move through the skin and other body tissues to the heart.
There, the waves bounce or “echo” off of the heart structures. The transducer picks
up the reflected waves and sends them to a computer. The computer shows the echoes
as images of the heart walls and valves. You will also have an electrocardiogram
(ECG) to record the electrical activity of your heart.
After the resting echocardiogram, you will exercise on a treadmill
or stationary bike for a certain period of time. You will have continuous ECG
monitoring, and your blood pressure will be checked periodically. You will then have
another echocardiogram during peak exercise and often just after peak exercise. The
healthcare provider will compare the resting echo images with those done during the
stress phase. Muscle areas that appear weaker during stress may mean you have
disease in the arteries of your heart.
You may need this test:
- To check for coronary heart disease
- To figure out how well your heart pumps and if the
structures such as valves are normal
- To be sure exercise is safe for you before you enter a cardiac rehab program, or
after you have had a heart attack or heart surgery
- To test blood pressure levels during exercise
- To see your heart status before surgery
- To assess symptoms of shortness of breath or trouble breathing that happens with
Your healthcare provider may have other reasons to advise this test.
Possible risks of this test are:
- Chest pain
- Very high blood pressure
- Heart rhythm problems
- Dizziness or lightheadedness, or feeling like you are going to faint
- Extreme tiredness (fatigue)
- Heart attack (rare)
There may be other risks based on your health. Talk with your healthcare provider
about any concerns before the test.
Your healthcare provider will tell you about the procedure. You
will also be asked to sign a consent form that gives your permission to do the test.
Read the form carefully and ask questions if something is not clear. For the
exercise part of the test, plan to wear loose, comfortable clothing and walking
You may need to fast before the test. Follow any directions you
are given for not eating or drinking before the test. In some cases, you may be told
to not have caffeinated drinks such as coffee, tea, and soda up to 12 hours before
testing. You may also be asked not to smoke, if you are a smoker.
Based on your condition, your healthcare provider may have other specific
instructions for you. For example, you may be told to not take medicines such as
beta-blockers before the test.
Tell your healthcare provider:
- If you are pregnant or think you could be
- If you take any prescription or over-the-counter medicines, vitamins, or
- If you have a pacemaker
- If you have any of these health problems:
- Severe high blood pressure
- Severe heart valve disease
- Severe heart failure
- Recent heart attack
- Low red blood cell count (severe anemia)
- Chronic lung diseases that affect your breathing while
- Muscle or bone problems that limit how you exercise
An exercise echo may be done on an outpatient basis. This means
you can go home the same day. Or it may be done as part of a hospital stay. The
process may vary based on your health and your healthcare provider’s practices.
Generally, the test follows these steps:
- You will be asked to remove any jewelry or other objects that may interfere
with the test. You may wear your glasses, dentures, or hearing aids if you
use any of these.
- You will be asked to remove clothing from the waist up and will be given a
gown to wear.
- You will be asked to empty your bladder before the test.
- You will lie on your left side for the first set of echo images. A pillow or
wedge will be placed behind your back for support.
- You will be connected to an electrocardiogram (ECG) monitor using small,
sticky electrodes. The ECG records the electrical activity of your heart and
monitors your heart during the test. The healthcare team will watch your
heart rate, blood pressure, breathing rate, and oxygen level. The ECG
tracing that records the electrical activity of your heart will be compared
with the images on the echocardiogram monitor.
- The room will be darkened so that the technologist can see the images on the
- The technologist will place warmed gel on your chest and then place the
transducer on the gel. You will feel slight pressure as the technologist
moves the transducer to get the desired image of your heart.
- The technologist will move the transducer around and use varying amounts of
pressure to get images of different places and structures of your heart. The
amount of pressure should not be uncomfortable. If it does make you
uncomfortable, tell the technologist.
- You may hear a “whoosh-whoosh” sound if you have a certain echocardiography
technique called Doppler or color Doppler. The sound is the blood moving
through your heart.
- Once the first set of resting images have been taken, you will start
exercising on the treadmill or stationary bike.
- You will exercise until you have reached your target heart rate based on
your age and health. Tell the technologist if you have any chest pain, leg
pain, breathing problems, severe tiredness, extra sweating, or heart
flutters (palpitations). This is at any point before, during, or after the
test. If so, the test will be stopped.
- Once you have reached your target heart rate, you may keep on exercising for
as long as you can. How long you can exercise is an important part of the
stress test result.
- Right after exercising, you will lie on the table or bed while the
technologist takes a second set of echocardiogram images.
- After the test is done, the technologist will wipe the gel from your chest
and remove the ECG electrode pads. You may then put on your clothes.
- Ask your healthcare provider when and how you will get the results of the
You may go back to your normal diet and activities, unless your healthcare provider
advises you otherwise. Generally, there is no special type of care after an exercise
echo. But your healthcare provider may give you other instructions.
You may get your test results the same day or at a later time. Ask your healthcare
provider or the technologist how and when you’ll get your results. Also ask if you
need to make a follow-up appointment.
Before you agree to the test or the procedure make sure you know:
- The name of the test or procedure
- The reason you are having the test or procedure
- What results to expect and what they mean
- The risks and benefits of the test or procedure
- What the possible side effects or complications are
- When and where you are to have the test or procedure
- Who will do the test or procedure and what that person’s qualifications are
- What would happen if you did not have the test or procedure
- Any alternative tests or procedures to think about
- When and how will you get the results
- Who to call after the test or procedure if you have questions or problems
- How much will you have to pay for the test or procedure