Stress Echocardiogram

Medically reviewed by Drugs.com. Last updated on May 4, 2025.

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What is a stress echocardiogram?

A stress echocardiogram (echo) is an ultrasound used to see how your heart works under stress. Your heart may be put under stress with exercise or medicine. An echo shows your heart structures and how well your heart muscle is pumping. It also shows how blood flows through your heart.

Why may I need a stress echo?

• Find the cause of symptoms such as chest pain or shortness of breath
• Monitor or diagnose a heart condition, such as coronary artery disease or a heart valve problem
• Find out how much exercise is safe for your heart
• Make sure your heart is strong enough for surgery

How do I prepare for a stress echo?

• Caffeine and nicotine can affect your test results. Do not have caffeine for at least 24 hours before your test. This includes drinks, foods, and medicine with caffeine. Do not smoke 3 hours before your test or as directed. Your healthcare provider may tell you not to eat or drink anything 2 hours before your test.
• Your healthcare provider will tell you what medicines to take or not take on the day of your test. You may be told to stop taking medicine with theophylline 48 to 72 hours before your test. You may also be told to stop taking beta blocker medicine 24 hours before your test. Wear comfortable clothes and shoes if you will exercise during the test. If you have an inhaler, bring it with you to the test.

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What will happen during a stress echo?

• A healthcare provider will place electrodes (sticky patches) on your chest. Hair may be removed to help the patches stick to your skin. Your healthcare provider will attach a wire to each patch. The wires are connected to a monitor that will display the electrical activity of your heart. An echo will be done while you are resting. If you are going to get medicine during your test, a healthcare provider will insert an IV.
• You will exercise or receive medicine to stress your heart. Your heart rate, heart rhythm, and blood pressure will be monitored closely during the test.
  • During a stress echo with exercise you will be asked to walk on a treadmill or pedal on a stationary bicycle. Instead you may lie down and pedal a bicycle. If you lie down to exercise, an echo will be taken while you exercise. The speed and resistance of the exercise machine may be increased over time. You will be asked to exercise for as long as you can. Your healthcare provider will tell you to stop exercising if you have shortness of breath, chest pain, or leg pain. Immediately after you stop exercising, another echo will be done.
  • During a stress echo with medicine your healthcare provider will inject medicine through your IV. An echo will be taken while the medicine is given. The medicine will make your heart beat faster and work harder. The medicine may make you feel anxious, dizzy, nauseous, shaky, or short of breath. You may also have mild chest pain. These symptoms should stop when your healthcare provider stops giving you medicine. Tell your healthcare provider if you have severe chest pain or dizziness. Other medicine may be given to treat severe chest pain or dizziness.

What will happen after a stress echo?

Your IV will be removed if you had one. You can usually return to work and your normal activities right away.

What are the risks of a stress echo?

Medicine or exercise may cause chest pain, dizziness, or a heart attack.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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