Exercise Echocardiogram

Exercise Echocardiogram

(Stress Echocardiogram, Exercise Echocardiography, Exercise Echo)

Procedure overview

What is an exercise echocardiogram?

An echocardiogram is a noninvasive (the skin is not pierced) procedure used to assess the heart's function and structures. An exercise echocardiogram is performed to assess the heart's response to stress or exercise. During the procedure, a transducer (like a microphone) sends out ultrasonic sound waves at a frequency too high to be heard. When the transducer is placed on the chest at certain locations and angles, the ultrasonic sound waves move through the skin and other body tissues to the heart tissues, where the waves bounce or "echo" off of the heart structures. The transducer picks up the reflected waves and sends them to a computer. The computer displays the echoes as images of the heart walls and valves.

After the resting echocardiogram images have been obtained, the person will begin to exercise on a treadmill or stationary bicycle. The doctor will compare the resting echocardiogram with the test done immediately after exercise.

An exercise echocardiogram may utilize one or more of several special types of echocardiography, as listed below:

Other related procedures that may be used to assess the heart include resting or exercise electrocardiogram (ECG or EKG), Holter monitor, signal-averaged ECG, cardiac catheterization, chest X-ray, computed tomography (CT scan) of the chest, electrophysiological studies, magnetic resonance imaging (MRI) of the heart, myocardial perfusion scans, radionuclide angiography, and cardiac CT scan. Please see these procedures for additional information.

Reasons for the procedure

An exercise echocardiogram, obtained after you have exercised on a treadmill or stationary bicycle, may be performed for the following reasons:

There may be other reasons for your doctor to recommend an exercise echocardiogram.

Risks of the procedure

Possible risks associated with an exercise echocardiogram include, but are not limited to, the following:

If you are pregnant or suspect that you may be pregnant, you should notify your doctor.

There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your doctor prior to the procedure.

Certain factors or conditions may interfere with the accuracy of an exercise echocardiogram. These factors include, but are not limited to, the following:

Before the procedure

During the procedure

An exercise echocardiogram may be performed on an outpatient basis or as part of your stay in a hospital. Procedures may vary depending on your condition and your physician's practices.

Generally, an exercise echocardiogram follows this process:

  1. You will be asked to remove any jewelry or other objects that may interfere with the procedure. You may wear you glasses, dentures, or hearing aids if you use any of these.
  2. You will be asked to remove clothing from the waist up and will be given a gown to wear.
  3. You will be asked to empty your bladder prior to the procedure.
  4. You will lie on your left side for the first set of echo images. A pillow or wedge will be placed behind your back for support.
  5. You will be connected to an ECG monitor that records the electrical activity of the heart and monitors the heart during the procedure using small, adhesive electrodes. Your vital signs (heart rate, blood pressure, breathing rate, and oxygenation level) will be monitored during the procedure. The ECG tracing that will record the electrical activity of the heart will be compared to the images displayed on the echocardiogram monitor.
  6. The room will be darkened so that the images on the echocardiogram monitor can be viewed by the technologist or doctor.
  7. The technologist will place warmed gel on your chest and then place the transducer probe on the gel. You will feel a slight pressure as the technologist positions the transducer to obtain the desired image of your heart.
  8. The technologist will move the transducer probe around and apply varying amounts of pressure to obtain images of different locations and structures of your heart. The amount of pressure behind the probe should not be uncomfortable. If it does make you uncomfortable, however, let the technologist know.
  9. The different echocardiogram techniques described above (M-mode, 2-D, 3-D, Doppler, and color Doppler) may be used. You will not be aware of the different techniques except that during the Doppler or color Doppler, you may hear a "whoosh-whoosh" sound, which is the sound of the blood moving through the heart.
  10. Once the echocardiogram initial images have been obtained, you will use the treadmill or bicycle to begin exercising.
  11. You will exercise until you have reached your target heart rate (determined by the physician based on your age and physical condition), or until you are unable to continue due to chest pain, leg pain, severe shortness of breath, or severe fatigue.
  12. Once you have reached your target heart rate, you may continue to exercise as tolerated, as exercise duration is an important component of the stress test result.
  13. You should notify the technologist if you feel any chest pain, breathing difficulties, sweating, or heart palpitations.
  14. Immediately following exercise, you will lie on the table or bed while a second set of echocardiogram images is obtained.
  15. After the procedure has been completed, the technologist will wipe the gel from your chest and remove the ECG electrode pads. You may then put on your clothes.

After the procedure

You may resume your usual diet and activities unless your doctor advises you differently.

Generally, there is no special type of care following an exercise echocardiogram. However, your doctor may give you additional or alternate instructions after the procedure, depending on your particular situation.

Online resources

The content provided here is for informational purposes only, and was not designed to diagnose or treat a health problem or disease, or replace the professional medical advice you receive from your doctor. Please consult your health care provider with any questions or concerns you may have regarding your condition.

This page contains links to other websites with information about this procedure and related health conditions. We hope you find these sites helpful, but please remember we do not control or endorse the information presented on these websites, nor do these sites endorse the information contained here.

American College of Cardiology

American Heart Association

National Heart, Lung, and Blood Institute (NHLBI)

National Institutes of Health (NIH)

National Library of Medicine


Top of Page return to top of page