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Dobutamine Stress Echocardiogram (dobutamine echo, pharmacological
echocardiogram)
 Definition:
An echocardiogram
(often called "echo" or “echocardiography”) is a graphic outline of the heart's movement,
valves and chambers. The
dobutamine stress echo test involves
infusing a medication through an intravenous (IV) line, called dobutamine,
while
you are closely monitored. The medication stimulates your heart and makes
it "think" it is exercising. The test
is used to evaluate your heart and valve function when you are unable
to exercise on a treadmill or stationary cycle.
Echocardiography is often combined with Doppler
ultrasound and color Doppler to evaluate blood flow across the heart’s
valves.
Your doctor uses dobutamine stress echo to:
- Determine how well your heart tolerates stress or exertion
- Evaluate the function of your heart and valves
- Evaluate the effectiveness of your cardiac treatment
plan
- Determine the likelihood of having coronary artery
disease and the need for further testing
To prepare for echocardiography:
- DO NOT eat or drink anything except water for four
hours before the test. DO NOT drink or eat caffeine products (cola,
Mountain Dew, chocolate products, coffee or tea) for 24 hours before
the test. Caffeine will interfere with the results of the test.
- Ask your doctor what medications should be taken on
the day of your echocardiography test. DO NOT take the following heart medications on
the day of the test unless your physician tells you otherwise or if
the medication is needed to treat chest discomfort:
- Beta blockers [for example: atenolol
(Tenormin), metroprolol (Lopressor, Toprol), Propranolol (Inderal)]
- Isorbide dinitrate (for example: Isordil,
Sorbitrate)
- Isosorbide mononitrate (for example:
Ismo)
- Nitroglycerin (for example: Deponit,
Nitrostat)
Your physician may also ask you to stop taking other heart medications
on the day of the test. If you have questions about your medications
— ask your physician. Do not stop any medication without
first talking with your doctor.
Since many over-the counter medications
contain caffeine (such as diet pills, No Doz, Excedrin and Anacin),
DO NOT take any over-the-counter medication that contains caffeine for
24 hours before the test. Ask your physician, pharmacist or nurse if
you have questions about other mediations that may contain caffeine.
- If you have
diabetes and take medications to manage
your blood sugar, ask your physician how to
adjust your medications the day of your test. Do
not take your diabetes medication and skip a meal before the test. If
you own a glucose monitor, bring it with you to check your blood sugar
levels before and after your echocardiography test. If you think your blood sugar is
low, tell the lab personnel immediately. Plan to eat and take your blood
sugar medication after your test.
- You can wear whatever you like.
You will need to change into a hospital gown to wear during the procedure.
Do not bring valuables.
What to expect:
- Before
the test, a a cardiac sonographer (an allied health
professional who has been trained specifically to perform ultrasound
examinations), nurse or physician will explain the procedure
in detail, including possible complications and side effects. They will
be available to answer any questions you may have.
- You will be given a hospital gown to wear.
- First a sonographer will gently rub ten small areas
of your chest, and place small sticky electrode patches to these areas.
The electrodes are attached to an electrocardiograph (ECG) monitor,
which charts your heart’s electrical activity during the test.
- An intravenous (IV) line will be inserted into a vein
in your arm so the dobutamine medication can be delivered directly into
your bloodstream. The cardiac sonographer will perform a resting ECG,
measure your heart rate and take your blood pressure.
- The sonographer will ask you to lie on your left side
on an exam table so he or she can perform a resting echo. The sonographer
will place a wand (sound-wave transducer) on several areas of your chest.
The wand will have a small amount of cool gel on the end, which will
not harm your skin. This gel helps get clearer pictures. This should
not hurt.
- The physician or nurse will administer the dobutamine
medication into the IV while the cardiac sonographer continues to obtain
echo images.
- The medication will cause your heart to react as if
your 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 lab personnel will ask how
you are feeling, and will check your EKG, blood pressure and heart rate.
Please tell them if you feel chest, arm, or jaw pain or discomfort;
shortness of breath, dizziness; lightheadedness; or or irregular heartbeats
immediately. This procedure is usually well tolerated, but occasionally
there are complications. Please consult the health care provide performing
the test about the associated risks.
- The lab personnel will watch for any symptoms or changes
on the ECG monitor that suggest the test should be stopped.
- The IV will be removed from your arm once all of the
medication has entered your bloodstream. As soon as your heart rate
is adequately high, echo pictures are taken.
- The dobutamine stress echo takes about 60 minutes.
The actual infusion time is usually 15 minutes. You should also plan
to stay in the waiting room for at least 30 minutes after completing
the procedure, or until all of the symptoms you have experienced are
resolved.
- After the cardiologist reviews your test, the results
will go into your electronic medical record. Your physician will have
access to the results and will discuss them with you.
Ask your doctor if you have any questions about the dobutamine
stress echo.
Find
a Cleveland Clinic Heart Center doctor who performs this procedure |
