Contrast Stress Echocardiography

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A contrast stress echocardiogram is a non-invasive cardiac test that combines a stress test and echocardiogram. Ultrasound images of your heart are taken before and immediately after you walk on a treadmill to determine how well your heart and blood vessels are working. A substance called a contrast agent is used to help improve the quality of the images collected. The contrast is administered by a technologist or nurse using an intravenous (IV) line.

Your doctor uses a contrast stress echocardiogram to:

  • Assess the wall motion of your heart in response to physical stress (on the treadmill).
  • To diagnose the presence or absence of coronary artery disease.

To prepare:

  • Avoid oily or greasy skin creams and lotions the day of the test, as the cream can interfere with the electrode-skin contact.
  • Take your usual medications unless otherwise directed by your physician.
  • You can eat, drink and take medications as you normally would.

What to wear:

  • Wear comfortable clothes and shoes that are suitable for walking on a treadmill, and bring a water bottle.

What to expect:

  • A technologist (sonographer) will explain the test to you, take a brief medical history, and answer any questions you may have. You will be asked to sign a consent form.
  • Your blood pressure, heart rate, and electrocardiogram (ECG) will be monitored before, during, and after the test.
  • You will be asked to remove all upper body clothing, and to put on a gown with the opening to the front, and lie down on an examination table.
  • Adhesive stickers called electrodes will be put onto your chest to capture an ECG. The sites where the electrodes are placed will be cleaned with alcohol and shaved if necessary. A mild abrasion may also be used to ensure a good quality ECG recording.
  • A contrast stress echo scan requires the use of a substance called a contrast agent. The contrast agent helps to improve image quality.
    A technologist or nurse will insert an intravenous (IV) line into a vein in one of your arms.
  • The sonographer will apply some gel to a small ultrasound probe called a transducer, they will then position it on your chest, and take several resting images of your heart. You may feel some discomfort from the transducer against your chest as the sonographer may need to apply some mild pressure to obtain the best images of your heart.
  • The sonographer may guide you to breath in and out at certain times and may ask you to roll onto your left side.
  • Next, you will undergo an exercise stress test. To do this, you will be asked to walk on a treadmill. The walk starts off slowly, then the speed and incline increases at set times. This usually takes about 10 minutes. Ultrasound images are collected again immediately after exercise.
  • You will be monitored throughout the test. If a problem occurs, the technologist will stop the test immediately. It is very important for you to tell the technologist if you experience any symptoms.
  • It takes about 45 minutes to complete the test.
  • Your contrast stress echocardiography test will be kept on file for comparison with future contrast stress echocardiography tests.

    After the procedure:

    • People can resume their normal daily activities, including driving, after the test. The data will be reviewed by a cardiologist and the results will be reported to your doctor. If necessary, you may be referred for additional testing or a consultation with a physician.