What is Stress Echocardiography?

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  • Written By: Emma Lloyd
  • Edited By: A. Joseph
  • Last Modified Date: 10 January 2019
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Stress echocardiography is a medical test in which the function of the heart muscle is evaluated. This test involves putting the heart under physical stress to evaluate how well it functions and whether blood flow is compromised. Evaluation is carried out with tests such as an echocardiogram (ECG) and blood pressure and heart rate monitoring. In most cases, the type of physical stress used in this test is cardiovascular exercise such as walking or running on a treadmill or using an exercise bike.

This test can be referred to in a number of different ways. Stress echocardiography is also known as the cardiac test, cardiac stress test, treadmill stress test and exercise stress test. It can be used to determine whether a congenital heart defect or other heart condition is affecting a patient’s heart function or to evaluate heart function after a heart attack or other cardiac event.

Stress echocardiography is used to evaluate heart function because physical stress causes the heart to pump harder. This is because physical stress requires increased blood flow around the body in order to ensure the body continues to receive an adequate supply of oxygen. Therefore, when the heart is under physical stress, the demands placed upon it by the body are greater. If the heart is not able to operate at full capacity when under physical stress, blood flow becomes compromised, increasing the risk of heart attack and other cardiac events.


During stress echocardiography, the patient will undergo a series of tests to measure his or her vital signs before, during and after physical exercise. Before the patient begins to exercise, his or her pulse and blood pressure are taken, and an ECG is used to measure the electrical energy emitted by the heart as it beats. These are termed baseline measurements, and they are compared with measurements recorded during and after the test to determine how heart function changes as a result of physical exercise.

After these baseline measurements are taken, the patient begins exercising. While exercising, he or she wears portable blood pressure, pulse and ECG equipment so that measurements can be recorded during the exercise. The patient must continue exercising until his or her heart rate reaches the target rate determined by the doctor overseeing the test. After the exercise part of the test is complete, the patient’s vital signs are monitored until they return to the baseline. The doctor then evaluates heart function according to how pulse, blood pressure and electrical activity changed during exercise, how rapidly the target heart rate was reached and how long it took for the measurements to return to normal after exercise ceased.

Even though the heart is placed under physical stress during the test, stress echocardiography is a safe procedure. This is because the stress occurs in a controlled environment, with doctors present at all times. In addition, people who are at risk of a cardiac event such as heart attack or arrhythmia are rarely asked to undergo this type of test. In the rare cases in which a patient has chest pain, dizziness or other cardiac symptoms during the test, the stress echocardiography test is ended immediately so that he or she can rest.



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