Skip to main content

Stress Echocardiogram

Medically reviewed by Last updated on Mar 5, 2023.


What you need to know about 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.

How to 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.

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.

Risks of a stress echo:

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

Call 911 for any of the following:

  • You have any of the following signs of a heart attack:
    • Squeezing, pressure, or pain in your chest
    • You may also have any of the following:
      • Discomfort or pain in your back, neck, jaw, stomach, or arm
      • Shortness of breath
      • Nausea or vomiting
      • Lightheadedness or a sudden cold sweat

Seek care immediately if:

  • You feel weak, dizzy, or faint.

Contact your healthcare provider if:

  • You have nausea or are vomiting.
  • Your skin is itchy, swollen, or you have a rash.
  • You have pain, redness, or swelling in the area where the medicine was injected.
  • You have questions or concerns about your condition or care.

Heart-healthy tips:

  • Do not smoke. Nicotine and other chemicals in cigarettes and cigars can cause heart and lung damage. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.
  • Create an exercise plan with your healthcare provider. Do not begin an exercise plan before you talk to your healthcare provider. Exercise helps to lower high cholesterol and high blood pressure. It can also help you maintain a healthy weight.
  • Maintain a healthy weight. If you are overweight, talk to your healthcare provider about how to lose weight. A weight loss of 10% can improve your heart health.
  • Eat heart-healthy foods. Include fresh fruits and vegetables in your meal plan. Choose low-fat foods, such as skim or 1% fat milk, low-fat cheese and yogurt, fish, chicken (without skin), and lean meats. Eat two 4-ounce servings of fish high in omega-3 fats each week, such as salmon, fresh tuna, and herring. Do not eat foods that are high in sodium, such as canned foods, potato chips, salty snacks, and cold cuts. Put less table salt on your food.
    Sources of Omega 3
  • Limit or do not drink alcohol. Ask your healthcare provider if it is safe for you to drink alcohol and how much is safe to drink. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor.

Follow up with your doctor as directed:

Write down your questions so you remember to ask them during your visits.

© Copyright Merative 2023 Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

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.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.