Patient information for dobutamine stress echocardiography

Please DO NOT DRINK CAFFEINE on the day of the test.

It is very important that you bring someone with you, who can accompany you home especially for the first hour after the scan.

This page describes the testing procedures involved in a dobutamine stress echocardiogram. The procedure may also be called a dobutamine stress echo. If you or a family member has additional questions, please feel free to discuss them with Dr Beeton.

Where do I go?
The echo room is in the Cardiology Department Level 2 (ground level from main entrance) opposite the MRI Department, at St Peter's Hospital, Guildford Road, Chertsey, Surrey, KT16 0PZ Switchboard: 01932 872000.

You will have the test in a private room, because you will need to take the top half of your clothes off and wear a hospital gown. There will often be no other staff in the echo department when you are having your echo, so please feel free to bring a friend or family member as chaperone.

What is a dobutamine stress echocardiogram?
In order to diagnose certain heart conditions, some heart studies require that the heart be subjected to "stress" or exercise. This allows the cardiologist to evaluate the heart while it is working its hardest. The dobutamine stress echo was developed for people who are unable to exercise on a treadmill or stationary cycle as required using a more traditional stress echo. In this test, you will be given dobutamine, a special medication that will stimulate your heart and make it think that it is actually exercising.

The dobutamine stress echo is a valuable diagnostic tool that allows the cardiologist to assess a number of different things including:

    The overall function of your heart's valves and chambers
    The clinical manifestations of many types of heart disease such as valvular problems, myocardial disease, pericardial disease, coronary artery disease and congenital heart disease
    Monitoring, evaluation and follow-up of medical treatments (drugs) or surgical procedures

Patient preparation
1. Wear comfortable clothing.
2. Do not eat for a minimum of 4 hours before the test. If your appointment is in the morning, do not eat after midnight the night before your test.
3. Drinking water is allowed before the test.
4. If you are diabetic, juice is allowed in the morning with insulin (1/2 dose). If you take pills to control your blood sugar, do not take your medication until after the test is complete.
5. DO NOT DRINK CAFFEINE (coffee, tea, cola) on the day of the test.
6. Stop taking beta-blockers (Bisoprolol, Atenolol, Carvedilol, Nebivolol, Propranolol – check the box as the marketing name may be different to the name of the drug), calcium channel blockers (Diltiazem or Verapamil) and nitrates (Isosorbide Mononitrate or Nicorandil) for 24 hours prior to your test unless directed otherwise by your doctor.
7.  Bring someone who can accompany you home especially for the first hour after the scan.

What happens during the dobutamine stress echocardiogram?
    You will be given a hospital gown and asked to remove clothing from the waist up.
    An ultrasound technician or sonographer will place electrodes on your chest to monitor your electrocardiogram (ECG). The electrodes are small, circular pads with a sticky substance to help them adhere to the skin.
    Your blood pressure and ECG will be monitored throughout the test.
    You will be asked to lie on your left side on an exam table. The sonographer will place a wand (the ultrasound transducer that directs the sound waves) on different areas of your chest. To facilitate movement on your skin, a small amount of gel is placed on the end of the wand.
    An intravenous line (IV) will be inserted into a vein in your arm so the dobutamine medication can be delivered directly into your bloodstream.
    Your doctor will begin the infusion of dobutamine into the IV while the ultrasound technician continues to record echo images. The medication will cause your heart to react as if you were exercising.
    The dobutamine may give you a warm, flushing feeling and some patients experience a mild headache.
    Throughout the test, your doctor and the ultrasound technician will ask how you are feeling. Be sure to tell them if you feel chest, arm or jaw pain or if you are, short of breath, dizzy or feel lightheaded.
    The IV line will be removed from your arm once all of the medication has entered your bloodstream.

Will I feel any pain or discomfort during the test?
You should not feel any pain or discomfort during the test. The gel on the ultrasound transducer may feel cool on your skin as it is moved across your chest.

How long does the test take?
Usually about 50-60 minutes. After the test, you may get dressed and go about your daily business.

How do I get the results of my echocardiogram?
Dr Beeton will write to your doctor with the results of your test.

Dr Ian Beeton
Consultant Cardiologist

T 07734 361756             
F 01483 227840             

Revised August 2017