Dobutamine Stress Echocardiogram
An echocardiogram is an ultrasound or sound wave test of the heart. Sound waves are transmitted from an instrument, called a transducer probe, into your body. The sound waves reflect (echo) off the heart to create pictures which can be seen on a screen.
When a patient is unable to walk on a treadmill it becomes necessary to use a medication called Dobutamine to replace the treadmill portion of the test. This test will help your doctor determine if there are any structural abnormalities within your heart and if there are any areas of your heart muscle that do not receive enough blood supply due to coronary artery disease. Areas of your heart, which may have been damaged from a previous heart attack, may also be seen. A series of images are obtained at during the infusion of the medication. You will be continuously monitored for blood pressure, heart rate, rhythm and ECG changes. The entire test usually takes approximately one hour.
The test is used to:
- Determine how well your heart tolerates activity
- Evaluate the function of your heart and valves
- Determine your likelihood of having coronary artery disease (blocked arteries)
- Evaluate the effectiveness of your cardiac treatment plan
Preparing for the test
- You must be fasting 8 hours prior to the test.
- Take all of your regular medications the morning of the test, unless otherwise instructed by your physician or procedure scheduler. If you have diabetes and take medications to manage your blood sugar, you may want to contact your family physician about how to adjust your medications the day of your test.
- Wear comfortable two-piece clothing. You will need to change into an exam cape to wear during the procedure
- Please remove all neck jewelry prior to the test.
- Please notify the RN or technologist performing the test if you have a history of glaucoma or asthma.
What to expect during the test
- Before the test, a cardiac sonographer (an allied health professional who has been trained specifically to perform ultrasound examinations) will place small electrodes to your chest. The electrodes will be attached to an electrocardiograph (ECG) monitor, which charts your heart’s electrical activity during the test.
- Before an IV is started, the sonographer will perform a resting ECG, measure your resting heart rate and take your blood pressure.
- You will be asked to lie on your left side on an exam table so he or she can perform a resting echo. The sonographer will place a transducer on several areas of your chest. It will have a small amount of cool gel on the end, which will not harm your skin. This gel helps get clearer pictures of the heart's movement. This should not hurt. Sounds are part of the Doppler signal. You will be able to hear the sounds of your blood passing through your heart valves during the test.
- Then, a nurse will insert an intravenous line (IV) into a vein in your arm and begin delivering the Dobutamine.
- A physician or physician assistant will be present during medication administration.
- The medication will cause your heart rate to react as if you were exercising; your heart rate will rise and you may feel it beating more strongly. It may cause a warm, flushing feeling and, in some cases, a mild headache.
- At regular intervals, the physician will ask how you are feeling. If you feel chest, arm or jaw pain or discomfort, short of breath, dizzy, lightheaded, irregular heart beats or if you have any other unusual symptoms, tell the physician immediately.
- Upon completion of Dobutamine infusion, the intravenous line will be removed and your heart rate, blood pressure and ECG will continue to be monitored until the levels have returned to normal.
- The entire test takes about 60 minutes.
What to expect after the test