Stress Echocardiogram

What is a Dobutamine Stress Echocardiogram (DSE) and Why do i need one?

A Stress Echocardiogram is a test which allows your Doctor to look at your heart at rest and also during ‘stress’ when it is beating faster (as if you have been exercising).

The test will help your Doctor to assess the response of the heart to stress and detect any effects on the pumping action of the heart which might be caused by narrowing of a coronary artery.

Do I need to do anything before the test?

You may be asked to omit certain medications for 48 hours before the test. These include Diltiazem, Verapamil and Betablockers, e.g. Atenolol, Bisoprolol, Carvedilol, Metoprolol, Nebivolol and Sotalol. All these medications slow the heart.

If you are a diabetic you should inform the department when you receive your appointment.

What will happen on the day?

You should not eat for at least 4 hours prior to the test. Take any other medication as normal.

If you use a nitrolingual spray you should take this with you to the appointment.

You should also take along a list of all the medications you are taking and let the staff know if you have any allergies or reactions to drugs or other tests.

Your blood pressure will be checked upon arrival and monitored throughout the procedure. If it is too high the Doctor may decide to postpone the test until it is at an acceptable level. In this case a letter would be sent to your GP to let him know and to possibly alter your medications.

The Doctor will explain the procedure to you.

The first part of the test will be a normal Transthoracic Echocardiogram (heart scan).

Your heart will then be ‘stressed’ by a drug called DOBUTAMINE. An additional drug called ATROPINE may also be given to help speed the heart up. The Dobutamine drug will slowly be injected, via a vein in your arm, until your heart reaches the target rate (this is calculated according to your age). Your blood pressure and ECG will be continually monitored throughout the procedure.

If you are having the stress echocardiogram as part of an investigation into chest pain, this may be provoked during the test. If this happens the test can be stopped at any time and the effects of the drug will usually disappear within a few minutes.

How long does it take?

The procedure may take up to 1 hour to complete.

What happens after the test?

Once the test is completed you will continue to be monitored until your heart rate returns to normal.

Although the effects of the test and Dobutamine should have worn off by the time you leave the department you should have a relative or friend drive you home.

Are there any risks or side effects?

Some side effects of a DSE are similar to exercise.

You may feel hot, sweaty or flushed. Your heart may be thumping and your pulse racing. These are normal effects of Dobutamine.

If Atropine was administered you may experience some blurred vision and a dry mouth, but these side effects will disappear soon afterwards.

Occasionally, Dobutamine can cause Angina, breathlessness and palpitations.

In rare cases drugs can be given to counteract the effects of the Dobutamine, e.g. in the event of prolonged angina or serious palpitations.

Serious side effects are very rare but these may include severe angina or heart attack requiring admission to hospital or severe palpitations leading to an unstable heart rhythm.