Stress ECHO Test

What is stress ECHO – stress echocardiography?

A stress echocardiography, also called an ECHO stress test or stress ECHO, is a procedure that determines how well your heart and blood vessels are working.


During a stress echocardiogram, you will exercise on a treadmill or stationary bike while the doctor monitors your blood pressure and heart rate.

When your heart rate reaches its maximum level, your doctor will take ultrasound images of your heart to determine whether your heart muscles are getting enough blood and oxygen while you exercise.


A cardiologist may request a stress test, i.e. a stress echocardiographic examination, if you have chest pains that he believes are the result of coronary artery disease or myocardial infarction. This test also determines how much exercise you can safely handle if you are undergoing cardiac rehabilitation.


The test can also show your doctor how well treatments such as bypass surgery, angioplasty, and antianginal or antiarrhythmic drugs are working.

Risks associated with the stress echo test

This test is safe and non-invasive. Complications are rare but may include:

  • abnormal heart rhythm
  • dizziness or fainting
  • heart attack

How to prepare for Stress Echo?

At Pulse Cardiology Center, this test is usually performed in the ergometry or echo lab, but may also be performed in a cardiologist’s office or other medical setting. A stress Echo test usually takes between 45 and 60 minutes.


Before you take the test, you should do the following:

  • Be careful not to eat or drink three to four hours before the test.
  • Do not smoke on the day of the test, as nicotine can interfere with your heart.
  • Do not drink coffee or take medications that contain caffeine without consulting your doctor.
  • If you are taking medications, ask your doctor if they should be taken on the day of the test. You should not take certain heart medications, such as beta-blockers, isosorbide dinitrate, isosorbide mononitrate, and nitroglycerin, before the test. Tell your doctor if you are also taking medication to control diabetes.
  • Wear comfortable, loose clothing. Since you will be exercising, be sure to bring good walking or running shoes.

What happens during a stress echo test?

Echocardiography at rest

A cardiologist needs to see how your heart works while you are at rest to get a clear picture of how your heart works. The cardiologist begins the test by placing 10 small sticky patches, called electrodes, on your chest. The electrodes are connected to an electrocardiograph (ECG).


An ECG measures the electrical activity of your heart, specifically the speed and regularity of your heartbeat. It is common to also measure blood pressure throughout the test.


After that, you will lie on your side and the doctor will do a resting echocardiogram or ultrasound of the heart. Doctor will apply a special gel to your skin and then use a device that emits sound waves to create images of your heart’s movements and internal structures.

Stress test

After a resting echocardiogram, your doctor will require you to exercise on a treadmill or stationary bike. Depending on your physical condition, doctor may ask you to increase the intensity of your exercise.


You will probably need 6 to 10 minutes of exercise, or until you feel tired, to get your heart rate up as much as possible.

Tell your doctor right away if you feel dizzy or weak, or if you have chest pain or left-sided pain.


As soon as your doctor tells you to stop exercising, the medical staff performs another ultrasound. Multiple pictures of your heart working under stress will be taken. Then you have time to “cool down”.  You can walk around slowly, so that the heart rate returns to normal. A cardiologist monitors your EKG, pulse and blood pressure until all levels return to normal.

Examination results

The echocardiography stress test is very reliable. The doctor will communicate and explain the test results to you. If the results are normal, your heart is working properly and your blood vessels are probably not blocked by coronary artery disease.


Abnormal test results may mean that your heart is not pumping blood efficiently because there is a blockage in the blood vessels. Another reason could be that a heart attack has damaged your heart.


Diagnosing coronary artery disease and early assessment of heart attack risk can help prevent future complications. This test can also help determine if your current cardiac rehabilitation plan is right for you.