Dobutamine Stress Echo

 

A dobutamine stress echocardiogram is a test that uses sound waves (ultrasound) to understand how your heart muscle functions under stress.

 

Dobutamine is a drug used to simulate the effect of exercise on your heart muscle.

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Why am I having a Dobutamine Stress Echo? 

Your referring doctor will consider this test when they are concerned that the symptoms you are describing are due to coronary artery disease. When you have coronary artery disease the blood vessels supplying oxygen to your heart become narrowed and blocked. Over time, reduced levels of oxygen can change the way your heart functions, especially under the stress of exercise.

A dobutamine stress echocardiogram is used to assess the structure and function of your heart under stress conditions like when exercising. This test will be recommended when a traditional exercise stress echocardiogram is not appropriate.

What happens during a Dobutamine Stress Echo?

This test takes place in a testing room and you will be asked to lie on an examination bed. At SouthWest Cardiovascular, there are usually three health professionals present in the room with you: a cardiac technician/nurse practitioner, an echocardiographer, and a doctor (either a general practitioner or a cardiologist).

The cardiac technician will ask you to take off your top so that they can attach stickers to your chest to monitor the electrical activity of your heart. A gown will be provided if required.

A blood pressure cuff will be placed on your arm.

The attending doctor will place a cannula into one of the veins in your arm so they can administer dobutamine intravenously.

Before you are given any dobutamine, the sonographer will use the ultrasound probe to take some picture of your heart at rest. They will apply a cold gel to your chest and use an ultrasound probe to take the pictures, you will feel slight pressure from the probe. They might ask you to hold your breath at points to get the pictures they need.

The nurse will then administer the dobutamine through your cannula, the dose will be slowly increased until your heart rate reaches its target level. Since dobutamine is biochemically very similar to adrenaline, you will feel your heart beating faster and more strongly, just like when you are exercising.

The sonographer will continue to take pictures of your heart using the ultrasound probe. You may be asked to hold your breath or move position so that they can capture the pictures required.

What are the risks of a dobutamine stress echo?

This is a common, safe test to understand how your heart is functioning, in a small number of patients they may develop chest pain, a change in blood pressure, irregular heartbeats, dizziness or nausea.

The risk of a major problem is rare and this will be discussed with you before the test when you sign the consent form. Generally, the risk of a heart attack is less than 1 in a 1,000 tests, cardiac arrest less than 1:5,000, and the risk of death is very rare at less than 1:10,000.

Your safety is our priority, so in some cases if these symptoms develop your medical team may decide to stop the test early.

How long does this test take?

A dobutamine stress echo will usually take 30 – 45 minutes to perform. The actual intravenous dobutamine infusion usually takes place for no more than 10 – 15 minutes. Overall, we recommend that you allow at least 1 hour for this appointment.

How do I prepare for a dobutamine stress echo?

You may be asked to withhold some of your medication for a day before the test. These instructions will be clearly communicated to you when your booking is confirmed

Please avoid caffeine, alcohol and smoking for two hours prior to this appointment. Do not eat for at least 1 hour before the test.

What to wear?

The cardiac technician will need access to your chest, so it is best to dress in a two-piece outfit on the day of your test.

What to bring?

Please ensure you bring a copy of your referral and a list of your current medication with you.

My results?

A cardiologist specialised in cardiac ultrasound imaging will assess your echo pictures, ECG and blood pressure and prepare a report for your referring doctor.