Stress tests with echo provide information about how the heart works during physical stress. Some heart problems are easier to diagnose when the heart is stressed and its beats are accelerated.
During the exercise stress test, an intense physical effort will be made (walking on the treadmill or pedaling a stationary bike). The activity of the heart will be evaluated while the patient will support the physical activity.
Doctors usually use echo stress tests as an aid in the diagnostic process of coronary heart disease, but also to find out the degree of severity of this type of condition.
Coronary artery disease is a condition characterized by the accumulation of atheroma plaque in the coronary arteries. These arteries supply the heart with oxygen-rich blood, and the atheroma plaque narrows the arteries and reduces blood flow to the heart muscle. These deposits also cause the formation of blood clots in the arteries.
How Much Does a Stress Test with Echo Cost?
In case you don’t have a health insurance policy, you should be prepared to spend anywhere between $800 and $2,700 for a stress test with echo.
Stress test with echo procedure
Before starting the investigation, the nurse will apply some electrodes to the patient’s skin. The electrodes will be connected to an EKG machine that will record the electrical activity of the heart.
The electrocardiogram shows how fast the heart beats and what is its rhythm. An EKG records the intensity and tempo of the electrical signals passing through the heart. The nurse will check your blood pressure during the stress test. It may be necessary for the patient to breathe into a special tube to measure the exhaled gases.
Then the patient will move on a stationary bike or on a treadmill. The exercise will become more and more difficult, but the patient can stop when it becomes too difficult to perform. If the patient cannot complete the exercise, he will be injected with a substance that will increase the blood flow through the coronary arteries and accelerate the heartbeat, so that the effort made by this organ is similar to that during the stress test.
The medicine can cause a state of anxiety and headache, but the effects disappear immediately after the end of the test. During physical exercises or after the administration of this medicine, the nurse will be interested in the patient’s condition to find out if chest pains, shortness of breath, or dizziness occur.
The duration of a stress test with echo is, according to current protocols, 9-15 minutes, rarely more. This is because it is considered that upon reaching a threshold of 85-90% of the maximum individually calculated level, the patient has a normal functional capacity, and if up to this threshold no suggestive EKG changes or symptoms that limit the effort appear, a significant cardiovascular disease, in principle, is excluded.
Important things to consider
In July 2012, the U.S. Preventive Services Task Force, an independent group that makes recommendations to doctors, recommended that stress testing with echo not be routinely performed on people without symptoms or strong risk factors for heart disease. Doctor groups such as the American College of Cardiology support this recommendation. The final decision, however, belongs to you and the doctor who knows your medical problems.
There are also situations where a person could have arthritis or another medical problem that could prevent them from doing the appropriate exercises during the stress test with echo. In this situation, the doctor will administer drugs to make the heart’s activity harder, in a way similar to that of physical exercises. This procedure is called a pharmacological stress test.
When is it advisable to do a stress test with echo?
The stress test with echo is recommended when:
- you are or will be included in a medical recovery program;
- you have cardiac symptoms (chest pain, difficult breathing on exertion, palpitations) suggesting an ischemic heart disease;
- you are a man over 40 years old or a woman over 50 years old and you intend to start a regular exercise program. These age limits can be, and it is even indicated to be, lower for those with a sedentary lifestyle, with cardiovascular risk factors present, or with a family history of heart disease;
- you belong to a group with medium or high cardiovascular risk (metabolic syndrome, diabetes, or multiple coronary risk factors), even if you have no symptoms;
- you are an amateur or performance athlete and you want to evaluate your functional capacity or detect situations in which the effort could be dangerous for your health (for example, limits or potentially pathological EKG changes).
- you are undergoing treatment for a known cardiovascular disease and the doctor wants an evaluation of the treatment or functional capacity.
Contraindications for the stress test with echo
It is strictly contraindicated to do an exercise test if you are diagnosed with:
- acute myocardial infarction or other acute coronary syndromes in the first 48 hours;
- very slow or very fast heart rates as well as therapeutically uncontrolled blood pressure values;
- acute myocarditis or pericarditis;
- acute pulmonary embolism;
- tight aortic stenosis;
- acute or chronic aortic dissection;
- physical, sensory, or mental disability, which prevents either a good doctor-patient collaboration or the safe performance of the decompensated heart failure test, with congestive phenomena present;
- rare heart diseases manifested by heart rhythm disorders, especially ventricular ones, which present an increased risk of arrhythmic death.
Possible complications of stress test with echo
An exercise stress test is generally safe. Possible complications of a stress test are extremely rare and consist of:
- low blood pressure during or immediately after exercise, which can lead to dizziness or fainting. The problem should disappear after the patient stops exercising.
- abnormal heart rhythms (arrhythmias) – occur during the test and usually disappear shortly after the exercise stops.
- although very rare, it is possible for an exercise test to cause a heart attack.