Stress Echo

1. A technologist or sonographer will give you a consent form to sign and will explain the test to you. They will be happy to answer any questions you may have about the procedure. However, they will not be able to discuss the results of the test or what they see on the screen, in any way.

2. You will be given privacy to change into a gown that will be provided to you. You will be asked to remove all upper body clothing and fasten the gown in the front. Making sure that you have running shoes or sneakers on and laced up, you will lie down on an examination table on your left side until the technologist returns.

3. Adhesive electrodes will be applied to your chest to set up for ECG monitoring. The electrode sites will be cleaned with alcohol and possibly shaved to ensure an interference-free and continuous ECG recording.

4. A technologist or nurse will insert an intravenous (IV) line into a vein in one of your arms.

5. The sonographer will apply some gel to a small ultrasound probe (a transducer) and will place it on your chest, pressing down at times to take images of your heart at rest. Your resting blood pressure, heart rate, and ECG will also be recorded.

6. Next, you will be asked to stand up and mount a treadmill that is located just steps away from the examination table.

7. You will begin walking on the treadmill at a slow introductory pace that will be increased every 3 minutes until your target heart rate is reached.

8. You will be monitored throughout the test. If a problem occurs, the technologist will stop the test right away. It is very important for you to tell the technologist if you experience any symptoms, such as chest pain, dizziness, unusual shortness of breath, or extreme fatigue.

9. Once the treadmill portion of the test is complete, you will need to quickly lie back down on the examination table, on your left side for a second echocardiogram. This time, the technologist will capture images of your heart working hard after exercising on the treadmill.

10. Your blood pressure, heart rate, and ECG will continue to be monitored for some time after the treadmill exercise. Your blood oxygen saturation may also be checked before and after the test and in some cases, a quick breathing test (spirometry test) may also be done before and after the treadmill portion of the stress echo.

11. Data from the test will be reviewed by a cardiologist in a timely fashion. A report will then be sent to your healthcare provider.

12. Following the test, you may resume your regular activities.

Your healthcare provider may have many reasons to call for a UEA stress echocardiogram to be done at this time. Since it is a multifaceted test that gives comparative information of your heart at rest versus when it is taxed with exercise, it can be used to investigate the causes of exercise-induced symptoms like shortness of breath, lightheadedness or palpitations. It is also instrumental in the diagnosis of coronary artery disease (CAD) and chest pain (angina) symptoms. As a result, UEA stress echo can help predict the development of cardiovascular conditions including the elevated risk of a cardiac event, such as a heart attack, occuring in the future. The test also helps us determine the appropriate course of treatment in cardiac rehab & risk reversal by indicating the safe-zone of exercise based on fitness level and cardiac functioning.

The UEA stress echo is meant to diagnose and prevent cardiac events from happening, not induce them. Complications during the stress portion of the test are extremely rare. Nevertheless, experienced medical staff who are trained to handle emergency situations are in attendance at all times. Patients are under constant cardiac monitoring during the test which means that it will be halted and appropriate medical attention will be received at the earliest sign.

Echocardiography is based on the same laws of nature that bats use to “see” in the dark (echolocation), that ships and fishermen use to navigate the deep sea (SONAR) and that obstetricians use to measure a baby in the womb (ultrasound). When a sound wave strikes an object, it bounces back, or echoes. By measuring these echo waves, it is possible to determine not only how far away an object is but also its size, shape and consistency.

In cardiology we use echocardiography ultrasound to detect changes in the appearance and functioning of the heart, its tissues, valves and vessels and to detect abnormal masses, such as tumors. This is facilitated by an ultrasensitive “wand” called a transducer which both sends sound waves into the body and receives the resulting echo. As the sound waves bounce off of internal organs, fluids and tissues, the transducer then receives the information and records tiny changes in the sound's pitch and direction. These signature waves are instantly measured and translated into an image that is displayed on the monitor.

Our commitment to the safe and effective use of technology in the diagnostics and treatment of our patients is unwavering. To that end, we have invested in the advanced technology of microbubble UEA echocardiography. As a pain-free, biocompatible, non-invasive test that involves absolutely no radiation, it goes above and beyond safety standards while providing improved image resolution and diagnostic accuracy.

The IV is inserted at the beginning of the appointment, however, the microbubble UEA liquid is only administered through the IV at certain phases of the appointment when it is specifically needed to enhance the ultrasound image. When an ultrasound is conducted in the presence of this IV liquid, the sound waves emitted by the machine bounce off of the microbubbles giving high-resolution, real-time, moving images of the heart, its chambers, vessels, valves and their functions. Microbubble UEA echocardiography provides a huge advantage in the accuracy and reliability of test results.

Where do these microbubbles end up eventually? Since the bubbles consist of an inert, biocompatible gas, the body simply breathes them out through the lungs. It will be as undetectable to the patient as breathing out carbon dioxide and other naturally occurring gases with each out-breathe.

Yes. OHIP covers your Stress Echo test provided it has been ordered for medical, diagnostic purposes. On some occasions, patients require Stress Echo monitoring for insurance or ministry of transportation assessment in which case, OHIP does not cover the test and the cost of the test is charged to the patient or their insurance directly.