Pharmacologic Stress Echocardiography
GENERAL INFORMATION:
What is pharmacologic stress echocardiography?
- Pharmacologic stress echocardiography (echo) uses medicines to make the heart work just as it does when you exercise. The test also shows the activity and movement of the heart as seen and recorded on a monitor. The medicines work on the blood vessels or muscles of the heart, and are safe to use as heart stressors. Stress makes the heart work harder to send more oxygen-rich blood to the body.
- Pharmacologic stress echocardiography uses sound waves to take images of the heart. Images before giving the medicines are compared with those during and after to know how the heart responds to stress. Heart activity is also monitored using electrocardiography (ECG) at all stages of the test. There are times when arteries of the heart get blocked and its muscles get damaged. When this happens, the heart must work even harder to supply oxygen-rich blood to the body. Heart damage, blockage and problems with the heart walls may be seen with this test. Having a pharmacologic stress echocardiography may help diagnose a heart condition and prevent further medical problems.
Who may need a pharmacologic stress echo? This test is done for those who have heart-related symptoms but cannot exercise. This may include any of the following:
- Elderly people who may have blocked arteries.
- People scheduled to have major surgery.
- People having chronic (long-term), or long-standing disease with heart problems.
- Younger people who may have heart disease but also have bone, joint, muscle, or nerve problems.
Why is a pharmacologic stress echo needed? Your caregiver may ask you to have this test to further diagnose your condition. The test may show if you are at risk of having a heart attack. It may also diagnose heart conditions, and check for changes in the heart activity including the rate and rhythm. These heart conditions may include heart disease and arrhythmias (abnormal heartbeats). This test may also help your caregiver decide if you could have surgery for other medical problems.
What medicines are used during a pharmacologic stress echo? The medicine used for this test is safe, but may have unwanted effects such as chest pain, shaking, trouble breathing, or skin flushing. There are two groups of medicines that may be used for this test:
- Medicines working on the muscles: These medicines include dobutamine and arbutamine. They work by increasing the activity of the heart muscles. The contractions (pumping) of heart muscles are made stronger and faster to increase the heart rate. An increased heart rate also increases blood flow.
- Medicines working on the blood vessels: These medicines include dipyridamole and adenosine. They work directly on the blood vessels of the heart. The arteries dilate (widen) to allow more blood flow. More blood flowing in the blood vessels carries greater amounts of oxygen to the tissues of the body.
How is a pharmacologic stress echo done? This test can be done in a clinic, a caregiver's office, or in a hospital.
- An intravenous (IV) line is placed in a vein of your arm.
- Electrodes (sticky patches) are stuck on your chest. If you have hair on parts of your chest or back, it may be shaved to help the patches stick to your skin. The electrodes will be attached to wires that send the electrical activity of your heart to the ECG monitor.
- A tracing of the heart is recorded while you are resting.
- Your caregiver will decide on the type of medicine to be used for your test. The medicine is given slowly by a caregiver, or a pump may be used.
- ECG tracings will be recorded during and after the medicine is given to you.
- Pictures of your heart while doing its work will be recorded using an echocardiogram. Echocardiography (ultrasound) makes use of high-frequency sound waves that gives your caregivers a moving picture of your heart. The sound waves are sent to the body with a special tool called a transducer. The sound waves hit the heart, bounce off, and return to the transducer as echoes. The echoes are changed into pictures on a monitor, and show a detailed view of your heart.
Who may not have a pharmacological stress echo?
- People having asthma attacks.
- People who used medicine that contains dipyridamole within the last 24 hours. Dipyridamole is a blood thinner. Ask your caregiver for more information about medicines that may contain dipyridamole.
- People who have had food or drinks that contain caffeine within the past 12 hours. This includes chocolate, coffee, tea, or sodas.
- People who have a heart rate of 40 beats per minute or less.
- People who have a systolic blood pressure number of less than 90 millimeters mercury (mm HG). The systolic number is the top number of a blood pressure reading.
- People who have uncontrolled hypertension (blood pressure more than 200/110 mm HG).
Where can I get more information?
- American Heart Association National Center
7272 Greenville Avenue
Dallas, TX 75231-4596
Phone: 1-800-242-8721
Web Address: http://www.americanheart.org
CARE AGREEMENT:
You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.
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