Dobutamine (stress) echocardiogram

A dobutamine (stress) echo combines a normal echo with a drug (dobutamine).

Performing an echo during exercise will help us find the cause of symptoms you may experience during physical stress or exercise. 

Getting high-quality pictures of the heart during exercise can be difficult. They can be affected by deep breathing and muscle tremor (shivers). For some patients, they are not able to exercise which can make performing an echo difficult.

As an alternative, we use a drug called dobutamine. This drug has similar effects to exercise on the heart and circulation. It increases your heart rate and the strength of its contractions without exercising.

The test

When you have the test, we will ask you to remove any clothing from the waist up. you will then lie down on an echo bed. We will attach 12 small sticky patches (electrodes) to your chest. This helps us to record your echo and electrical activity of your heart (electrocardiogram or ECG).

We then insert a small plastic tube (cannula) into a vein in your arm. We will take the first echo images and then inject a very low dose of Dobutamine through the cannula in your vein. 

We increase the drug in small doses every three minutes. We may also give you a dose of contrast (dye), which outlines the heart and makes the pictures easier to read. 

The dye should not have any major side effects for most people, but you must let us know if you have any allergies or concerns.

When you have the test, you will notice that your heart is beating faster and stronger, as if you were exercising. When you reach your target heart rate - which we calculate based on your age - we will stop giving you the drug.

We may stop giving you the drug early if you start experiencing:

• chest discomfort

• shortness of breath

• weakness

• dizziness

• significant changes in your blood pressure or ECG.

Once we stop giving you the drug, we will take a second echo. The effects of the drug will wear off in two to three minutes.

If your heart rate does not increase enough, we may give you another drug called atropine.

Before the test

You may need to stop taking specific heart medicines two to four days before the test. We will tell you when you book your appointment if you need to do this. If you are unsure, ask. It is best to not eat a heavy meal in the two hours before your test.

You will not be allowed to drive after this test, so you will need to arrange for someone to drive you home.

You must tell us if you are:

• pregnant or think that you may be pregnant (there is a risk of injury to the fetus from dobutamine)
• lactating or breastfeeding
• allergic or sensitive to medications or latex.

The test can take up to an hour, including preparation and recovery time. Once you feel recovered, you can usually go straight home.

Benefits

This test helps us to find out why you are experiencing symptoms from physical stress or exercise. We would do this test if you cannot do our normal exercise test.

We are able to get high-quality images of your heart with deep breathing or muscle tremors interfering with the images.

We also use this test to check if certain parts of the heart have experienced permanent damage after a heart attack or can recover.

This information will help us decide and manage your treatment.