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Stress Echo Information

Brief description
A dobutamine stress echocardiogram is a diagnostic procedure used to evaluate the heart muscle under stress; by combining intravenous medication called dobutamine with transthoracic echocardiography (heart ultrasound).There is no radiation involved. The echocardiogram uses ultrasound waves to produce images of the heart. Dobutamine causes the heart to beat stronger and faster and will mimic the effects of exercise. Images of the heart at rest are compared with images during dobutamine infusion and/or at peak stress, to evaluate how the heart responds.
  • This test is a good way of assessing whether your chest pain or discomfort is caused by coronary heart disease. It may be due to other problems.

  • It is usually recommended if you are unable to do a treadmill exercise test or if your exercise test has been inconclusive.

  • If we already know you have coronary heart disease or angina, dobutamine stress echocardiography can help the doctor assess the condition of your heart and plan further treatment.

  • If you like help completing the form, please ask a member of our staff.

  • Please ask about anything you do not fully understand or wish to have explained in more detail.

  • Remember, you can change your mind about having the procedure at any time even after you have signed the form.

  • The test can take up to half an hour to complete, and we ask you stay at the clinic for another half an hour afterwards. It is best that you do not drive after the test.

  • It is also advisable to avoid alcohol, caffeinated drinks for the day after the test.

Intended benefits of the test
  • Diagnose or exclude coronary artery disease.

  • Assess prognosis in patients with known coronary artery disease.

Who will perform my test?
  • The test is performed by two specially trained health care professionals.

  • The echocardiogram will be performed by a senior echo cardiographer who will also monitor blood pressure and Electrocardiogram (ECG) throughout.

  • A cardiologist(heart doctor) will administer the dobutamine infusion and supervise completion of the test.

Serious or frequently occurring risks

  • Serious side effects are rare. The risk of irregularity of heart rhythm with dobutamine is between 10 to 15 patients per 5,000 procedures.

  • The risk of death is between 1/5,000 and 1/14,000..

  • Reasonably common quickly reversible side effects with dobutamine include flushing, tingling, tremor, palpitations and desire to urinate.

  • Atropine can cause reversible side effects such as dry mouth, dry eyes, and difficulty passing urine, dilated pupils and double vision.

  • Sonovue (ultrasound contrast agent) side effects are usually mild and transient.

  • Rarely, allergic reaction can occur, including anaphylaxis (1 in 20,000).

  • Resuscitation medication and equipment is always immediately available in test room.

Information and support
  • You might be given some additional patient information before or after the test.

  • If you have any questions or anxieties, please feel free to ask a member of staff.

Before your procedure
  • The doctor who has requested the test will advise you about any medication (for example, Beta-Blocker) which you may need to stop for 48 -72hours before the test. All other medication should be taken as normal.

  • We advise that a friend or relative accompanies you to the clinic and also escorts you home. Be prepared to be in the clinic for up approximately one and half hours.

  • If your test is in the morning please drink water or a non-caffeine drink and have a normal breakfast.

  • If your test is in the afternoon, have a normal breakfast and lunch but no caffeine drinks for four hours before your appointment time.

  • If you have diabetes, please continue to take your meals and medication at the usual times.

  • Please try not to smoke or use nicotine containing substances for at least four hours before your appointment.

  • Please inform the doctor if you have any drug allergies.

Visit to the clinic for the test
  • You will be escorted into an examination room.

  • The room will have a special examination table, an ECG machine and echocardiogram (ultrasound) machine.

  • You will then be asked to remove your clothing from the waist up. Women will be given a gown to wear.

  • Your heart trace (ECG) will be monitored throughout the test.

  • A cardiac physiologist will attach ECG electrodes to your chest with simple medical tape. To ensure the ECG lead wires stay attached, we will clean your skin and prepare it for the electrodes. For men, it may be necessary to shave small areas of chest hair.

  • A blood pressure (BP) cuff will be placed on your arm.

  • The doctor will insert an intravenous (IV) cannula into a vein in your arm.

During the test
  • You will be asked to lie on your left side for the duration of the test.

  • The room lights will be dimmed to allow ultrasound images of your heart to be recorded. The sonographer will obtain resting images.

  • A small amount of contrast agent is injected intravenously in order to improve image quality.

  • Dobutamine infusion will begin at low dose and will be gradually increased every three to five minutes in order to speed up your heart. The test will continue until your predetermined target heart rate is reached. A small amount of Atropine may be given intravenously to allow your target heart rate to be reached.

  • Please let us know if you experience any chest pain, severe shortness of breath, dizziness, or feel unwell in any way.

  • ECG and BP readings will be taken throughout the test.

After the test
  • You will be asked to remain on the examination table until your heart rate and blood pressure have returned to normal.

  • Following this, the blood pressure monitoring cuff will be removed from your arm, ECG electrodes taken off your chest and intravenous cannula taken out from your arm vein.

  • You will then be escorted to a waiting area and asked to wait in the reception for approximately half an hour. You can then go home, if you feel back to your normal self

  • If you feel unwell, then you will be reviewed by the physician.

  • It is best that you do not drive for a few hours after the test, especially if you have been given atropine.

  • You can recommence any medication (such as Beta-Blocker) that may have been stopped for 48 hours prior to the test.

  • You can resume normal activities.

  • The ultrasound images will be interpreted by the physician who supervised your test and will provide your doctor with a written report.

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We look forward to seeing you at our clinic