It is one of the diagnostic tests that are carried out in cardiology services, and through it images of the heart are obtained. But, how is the stress echocardiogram performed? And when is it indicated?
As explained by Dr. Alex Ruiz Majoral, from the Bellvitge University Hospital Cardiology Service, in this video from the #telodigodecorazón section , it is performed on those patients suspected of having a coronary disease. For example, when they have chest pain, since stress echocardiography allows a diagnosis of alterations or disease of the coronary arteries . It is also performed in patients who are already known to have coronary disease because performing this stress echocardiography allows a more precise assessment, being able to know if the medication that the patient is taking is sufficient.
It is not only indicated in those patients who may have some instability because they have unstable angina with recent or recurrent episodes, or they have a situation of heart failure that is not compensated. In such cases, other diagnostic possibilities should be considered.
How it is performed
This technique is based on ultrasound echocardiography of the heart, and is first performed in a basal state of rest to later carry out a study after having made an effort. By means of a transducer that moves through the thorax, images of the heart in movement are obtained. The objective is to provoke situations in which there may be abnormalities of the heart that may go unnoticed at rest but appear during exercise or exertion .
First, the patient lies down on a stretcher, from where a complete echocardiography is performed, in which the contractility or motility of the different myocardial territories, which in turn depend on different coronary arteries, is observed.
To do this, the patient is placed electrodes on the chest to perform electrocardiograms. Subsequently, the patient is placed either on a treadmill or on a bicycle where he exercises. This exercise follows a preset protocol that gradually increases. At each stage, an electrocardiogram, heart rate, blood pressure, and motility or contractility of all myocardial territories are recorded .
During the examination, it is important that the patient warns of any symptom or discomfort that is presenting because, on occasions, the suspension or completion of the test must be assessed. If there are no symptoms, the patient continues to exercise until they reach a state of fatigue or exhaustion or until they reach a sufficient heart rate, which is previously calculated according to the patient’s age.
Once you have performed the exercise, you must remain at rest during a recovery phase where all your constants – heart rate, blood pressure and electrocardiographic recording and possible echocardiographic alterations that have appeared – return to their baseline situation.
The duration of the test ranges between 45 and 60 minutes. The patient must be fasting for about three hours before performing the test. It is also advisable to avoid copious meals and the consumption of coffee or tea beforehand. Medications can continue to be taken if they are considered essential. It is recommended that you come with comfortable clothes and sports shoes.
