Stress Echocardiography

A stress echocardiogram is a sophisticated cardiac test that combines an echocardiogram (heart ultrasound) and an exercise stress test. Beyond the information provided by an echocardiogram, this test compares how your heart muscle contracts at rest with how it contracts immediately following exercise.

It is usually performed to investigate cardiac symptoms such as chest discomfort or shortness of breath. It can also show if any parts of the heart muscle are not receiving enough oxygen-rich blood, which could indicate a narrowing or blockage of one or more coronary arteries. It is also occasionally performed for other reasons such as to assess heart muscle problems (cardiomyopathies), valve disease or heart rhythm disturbances.

Initially, ECG electrodes (sticky dots) with leads are attached across your chest to monitor your heart rhythm throughout the test. A blood pressure cuff is applied to your upper arm to monitor your blood pressure at regular intervals throughout the test. The test itself takes between 30 and 45 minutes to complete and is divided into three parts:


Baseline Echocardiogram

A baseline echocardiogram (cardiac ultrasound) is performed by an experienced cardiac echocardiographer with a focus on heart muscle function and identification of heart problems which may be contributing to chest pain, shortness of breath or dizziness (e.g., heart valve dysfunction, weak hurt muscle function, high pressures in the heart or lungs).


Exercise Stress Test

An exercise stress test is then performed under the direct supervision of Dr Nasis. The treadmill starts slowly and increases in incline and speed every 3 minutes according to a standard protocol (Bruce protocol), although this can be modified if required. The duration of exercise is generally limited by your symptoms, which means we will continue to increase the level of stress until you need to stop, which is usually because of shortness of breath or leg fatigue.


Recovery Period

Immediately after exercise, you are quickly move onto the bed where heart ultrasound images are again acquired within 60-90 seconds, followed by clinical and heart rhythm monitoring during the recovery period which usually lasts for approximately 5 minutes.


A stress test with monitoring is the safest environment to push yourself physically as you are closely monitored under the supervision of Dr Nasis. A common misconception is that you need to be fit or be able to run to undertake this test – this is not the case as the test is modified to obtain the necessary information at each individual’s capacity. This usually involves a maximum of walking quickly uphill with most people lasting on the treadmill between 5 and 15 minutes.

Prior to the test, please continue to take your regular medications (unless otherwise advised by your doctor), avoid eating for 1 hour prior to the test and wear comfortable walking shoes and loose-fitting clothing.

After the test, Dr Nasis will analyse all of the imaging, electrical, clinical and haemodynamic data to synthesise a report for your doctor. He will also discuss the results with you at the time and if necessary, will ring your referring doctor to discuss any urgent results and suggest any additional follow-up that is required.

Stress Echocardiography in Australia

Contact Dr Arthur Nasis for further information.