What is a stress echocardiogram?

A stress echocardiogram is a test that combines a stress test with an echocardiogram. The test evaluates the health of your heart at rest and after it is stressed. Your doctor may perform a stress echocardiogram to help diagnose coronary artery disease, and to see how well your heart pumps blood and how well your heart valves work.

An echocardiogram is a type of ultrasound or sonogram. It uses sound waves to make moving pictures of your heart. A stress test involves walking on a treadmill and having an EKG (electrocardiogram) to see how the stress of exercise affects the heart.

A stress echocardiogram, also called a stress echo or an echo stress test, is only one method to monitor and diagnose heart conditions. Discuss all of your testing options with your doctor to understand which options are right for you.   

Why is a stress echocardiogram performed? 

Your doctor may recommend a stress echocardiogram to evaluate the health of your heart at rest and immediately after the stress of exercise. It is not a routine test, and a stress echocardiogram by itself cannot diagnose all types of heart conditions or predict future heart problems. It does provide important information about your heart health in relation to your age, physical exam, medical history, and other tests. 

Doctors use stress echocardiograms to help diagnose or monitor the following conditions:

  • Cardiomyopathy, thickened or enlarged heart muscle 
  • Coronary artery disease (CAD), a buildup of plaque on the walls of the coronary arteries that supply blood to the heart
  • Heart attack, death of a portion of the heart muscle usually due to coronary artery disease and a blood clot that blocks blood flow to the heart
  • Heart failure, an inability of a weakened heart to pump enough blood to the body
  • Heart murmurs, unusual or abnormal heart sounds heard with a stethoscope
  • Heart valve disease including narrowed valves and leaky valves 
  • Pulmonary hypertension, increased blood pressure in the blood vessels that carry blood from the heart to the lungs

Your doctor may also perform a stress echocardiogram to:

  • Determine if your symptoms are related to coronary artery disease (narrowing of the coronary arteries). Symptoms can include chest pain, dizziness, shortness of breath, fatigue, weakness, palpitations, passing out, or feeling a pounding, racing or irregular heartbeat
  • Develop a healthy, safe exercise program if you have heart disease or a high risk of heart disease due to diabetes, family history, obesity, and other conditions
  • Further evaluate abnormal heart test results such as changes on a standard resting EKG
  • Monitor your heart condition after a heart attack or heart surgery

Who performs a stress echocardiogram?

A specialized medical team performs a stress echocardiogram. The team may include a doctor, nurse or technician and a sonographer, who is trained to perform echocardiograms. The following doctors can lead the team that performs your stress echocardiogram:

  • Cardiologists and pediatric cardiologists specialize in conditions and diseases of the heart and its blood vessels. Pediatric cardiologists further specialize in treating infants, children and adolescents.
  • Diagnostic radiologists specialize in performing and interpreting imaging tests, such as ultrasounds, X-rays, angiograms, CTs, nuclear scans, and MRIs.
  • Clinical cardiac electrophysiologists specialize in diagnosing and treating abnormal heart rhythms (arrhythmias) using heart and blood vessel imaging and technical procedures.
  • Interventional cardiologists specialize in diagnosing and treating conditions and diseases of the heart and blood vessels using nonsurgical, catheter-based procedures and specialized imaging techniques.
  • Cardiac surgeons specialize in the surgical treatment of conditions of the heart and its blood vessels. Cardiac surgeons may also be known as cardiothoracic surgeons.

How is a stress echocardiogram performed?

Your stress echocardiogram will be performed in a stress test laboratory in a hospital or heart clinic. The entire stress echocardiogram takes one to two hours and generally includes these steps: