Dobutamine Stress Echo Test

What is a dobutamine stress echo test?
The dobutamine stress echo test involves taking a medication 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.

The test is also used to:

• Determine how well your heart tolerates activity;
• Determine your likelihood of having coronary artery disease (blocked arteries); and
• Evaluate the effectiveness of your cardiac treatment plan.

Can I eat or drink on the day of the test?
Yes. However, DO NOT eat or drink anything except water for 4 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 your test.

DO NOT take these heart medications for 24 hours before your test unless your physician tells you otherwise, or unless the medication is needed to treat chest discomfort:

• Beta blockers [atenolol (Tenormin), metoprolol (Lopressor, Toprol), Propranolol (Inderal)]
• Isosorbide dinitrate (Isordil, Sorbitrate)
• Isosorbide mononitrate (Ismo, Indur, Monoket)
• Nitroglycerin (Deponit, Nitrostat, Nitropatches)

Medications containing caffeine
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 medications that may contain caffeine.

Diabetes medications
If you take insulin to control your blood sugar, ask your physician what amount of your medication you should take the day of the test. Often, your physician will tell you to take only half of your usual morning dose and to eat a light meal 4 hours before the test.

If you take pills to control your blood sugar, do not take your medication until after the test is complete.

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 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.

What should I wear the day of the test?
You may wear anything you like. Before the test, you will change into a hospital gown. Please do not bring valuables with you the day of the test.

Who will answer my questions before the test?
Before the test, a cardiac sonographer, nurse or physician will explain the procedure in detail, including possible complications and side effects. They will be able to answer any questions you may have.

• A cardiac sonographer will gently rub ten small areas on your chest and place electrodes (small, flat, sticky patches) on these areas. The electrodes are attached to an electrocardiograph monitor (EKG) that charts your heart’s electrical activity during the test.
• An intravenous line (IV) will be inserted into a vein in your arm so the dobutamine medication can be delivered directly into your bloodstream.
• The sonographer will perform a resting EKG, measure your resting 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 echocardiogram (also called an "echo"). An echocardiogram is a graphic outline of the heart’s movement created from ultrasound vibrations echoed from the heart’s structures. The sonographer will place a wand (called a transducer) on your chest so the physician can see the outline of the heart’s movement. Images will be taken periodically throughout the test.
• The physician or nurse will administer the dobutamine medication into the IV while the technician continues to obtain echo images.
• The medication will cause your heart 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 lab personnel will ask how you are feeling. Please tell them if you feel chest, arm or jaw pain or discomfort, short of breath, dizzy, lightheaded, or any other unusual symptoms.
• The lab personnel will watch for any changes that suggest the test should be stopped.
• The IV will be removed from your arm once the test is completed. Your heart rate should return to normal in about 5 to 10 minutes.

How long does the test take?
The appointment will take about 60 minutes. The actual infusion time is usually about 15 minutes. You should plan to stay in the waiting room for at least 30 minutes after completing the procedure, or until all of the symptoms you experienced have resolved.

How do I get the results of my test?
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.