Stress Echocardiogram

  • Stress echocardiography, also called an echocardiography stress test or stress echo, is a procedure used to determine how well your heart and blood vessels are working.
  • You will be asked to exercise on a treadmill or stationary bike while doctors monitor your blood pressure and heart rhythm. When your heart rate reaches peak levels, the doctor will take ultrasound images of your heart to determine whether your heart muscles are receiving enough blood and oxygen while you exercise.
  • The test can also determine how well treatments such as bypass grafting, angioplasty, or anti-anginal, or antiarrhythmic medications are working.


  • This test is usually done in an echocardiography laboratory (echo lab), but can also be performed in a doctor’s office or other medical setting. It normally takes between 45 and 60 minutes.
  • If you are a smoker, do not smoke on the day of the test because nicotine can interfere with your heart rate.
  • Do not drink coffee or take any medications that contain caffeine without consulting your doctor.
  • If you take medications, ask your doctor whether you should take them on the day of the test. Certain heart medications (such as beta-blockers, isosorbide dinitrate, isosorbide mononitrate, and nitroglycerin) should not be taken before the test. Also let your doctor know if you take medication to control diabetes.
  • Wear comfortable, loose-fitting clothes. Since you will be required to exercise, make sure to wear good walking or running shoes.


Resting Echocardiography

  • Your doctor will need to see how your heart functions while you are at rest to get an accurate idea of how it is working. The doctor will begin by placing 10 electrodes (small, sticky patches) on your chest that are connected to an electrocardiograph (ECG). The ECG will measure your heart’s electrical activity, especially the rate and regularity of your heartbeats. You will likely have your blood pressure taken throughout the test, too.
  • Next, you will lie on your side and the doctor will do a resting echocardiogram, or ultrasound, of your heart. He or she will apply a special gel to your skin and then use a device called a transducer, which emits sound waves to create images of your heart’s movement and internal structures.

Stress Test

  • After the resting echocardiogram, you will exercise on a treadmill or stationary bicycle. Depending on your physical condition, the clinician may ask you to increase the intensity of your exercise. How long you will need to exercise varies from person to person, but usually from 6-10 minutes.
  • You will likely be asked to exercise until you feel tired in order to raise your heart rate as much as possible. Let the clinician know right away if you feel dizzy or weak, or if you experience chest pain or pain on your left side.

Stress Echocardiography

  • As soon as the clinician tells you to stop exercising, he or she will perform another ultrasound. This is to take more images of your heart working under stress. You will then have a cool-down period when you can walk around slowly so that your heart rate can return to normal. The clinician will monitor your ECG, heart rate, and blood pressure until the levels return to normal.


  • This test is safe and non-invasive. Complications are rare, but can include:
    • an abnormal heart rhythm
    • dizziness or fainting
    • heart attack
  • There may be other possible risks. When you meet with your doctor, please ask questions to make sure you understand why the procedure is recommended and what the potential risks are.