What is a Pharmaceutical Stress
Echo?
Exercise treadmill testing is the standard "screening
device utilized to try to detect the presence or absence of significant coronary artery
disease (hardening of the arteries to the heart). For many patients, however,
treadmill testing cannot be performed adequately due to arthritic conditions of the hips
or knees or sometimes other medical conditions. For these individuals,
pharmaceutical stress echocardiography has been developed.
A variety of different pharmaceutical agents may be
utilized to "trick" the heart into thinking that it is exercising. These
include Dipyridamole, Adenosine and Dobutamine. The latter medicine is
commonly combined with ultrasound technology (echocardiography) to assist your physician
in determining the presence or absence of coronary artery disease.
It has been shown that heart muscle with poor blood
flow may move normally at rest but lose its ability to contract normally during and
immediately after an episode of increased heart rate. This loss of contractility
maybe detected by echocardiography during a pharmaceutical stress echocardiographic study.
How is the test done?
The Dobutamine Stress Echo is performed by obtaining four
standard views of the heart at rest and placing the images into a digital computer for
analysis at a later time.
Through an intravenous (IV) line a measured dose of
Dobutamine (a medication that stimulates the heart) is administered in stages to stimulate
the heart as though you are exercising.
The heart is monitored with both EKG and
echocardiography throughout the test with sample images stored into the computer at
various stages.
Preparation for the
Dobutamine Stress Echo
-
Unless told otherwise do not eat or drink for three hours
prior to the test.
-
Take your medications unless told otherwise.
-
Wear loose comfortable clothing. Women will be asked
to wear a cape from the waist up.
-
Bring a current list of medications with you.
-
Report any symptoms during the test.
What to Expect During the Test:
-
The test will be explained to you and you will be asked to
sign a consent form. Feel free to ask any questions you may have about the test.
-
Several EKG electrodes will be applied to your chest.
-
An intravenous line will be placed in hand or arm.
Dobutamine will be infused in stages to stimulate your heart.
-
You will be asked to lie on your left side while the
resting images are obtained and will remain in that position for the duration of the exam
while echocardiographic images are continuously monitored.
Preliminary results are usually available
immediately after the test. The final results will be sent to your doctor within a
few days. The information that is provided by the stress echocardiogram would help
your doctor make an accurate diagnosis and develop a treatment plan. He or she can
then go over the results and any needed treatment options in detail.
After the Test:
You will be monitored for a short time after the test.
You will be free to resume your normal activities.
Prognostic Information:
An article in the June 1999 issue of the Journal of the
American Society of Echocardiography demonstrated that a negative (normal) dobutamine
echocardiographic study was associated with an excellent prognosis. Individuals with a
normal study had a very low cardiovascular event rate (heart attack or death) for the next
five years.
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