Dobutamine Stress Echocardiogram

What is Dobutamine Stress Echocardiography ?

A dobutamine (stress) echo combines a normal echo with a drug (dobutamine) which has similar effects to exercise on the heart and circulation. This is an alternative way of stressing the heart for people who are unable to exercise on a treadmill. Dobutamine is an adrenaline-like medicine that makes your heart pump harder and faster like exercise does. We use dobutamine instead of treadmill exercise in people with poor health, joint problems, poor circulation in their legs, lung problems or the elderly. The test is performed while you lay on a couch on your left side. ECG electrodes are attached to your chest to monitor the electrical activity of your heart during the test. A blood pressure cuff is applied to your arm to monitor your blood pressure and automatically inflates every few minutes throughout the study. An intravenous (IV) will be placed in your arm and dobutamine will be given to you through this IV. Initially you will feel nothing at the start, but it is normal for you to feel your heart beat harder and faster with higher doses of the drug. Sometimes the dobutamine may cause some chest discomfort, nausea or shortness of breath. Throughout the study, your heart will be continuously imaged with ultrasound. It is important that you tell us if you feel anything uncomfortable or unusual during the test.

To prepare for this test, you must not eat for one hour prior to the test, however you can drink water prior to the test. Medicines which are Beta blockers & Calcium channel blockers need to be stopped 48 hours prior to the test. The dobutamine stress echo test takes approximately 1 hour, including preparation and recovery time.

What happens afterwards?

When the test is over, the dobutamine is stopped and your heart beat soon returns to normal. The IV is then removed from your arm and you will be able to go home. You may feel a little tired after the test, but you should soon feel normal again. If you have any problems after the test or if you have any questions, please call your doctor. The results will be discussed with you after the test. Any ongoing treatment will also be discussed and the need for any further follow up. Your referring doctor and local GP will also get the results.

Are there any risk?

There are no known risks from the clinical use of ultrasound for scanning. The dobutamine (stress) test is very safe and widely used in patients with chest pain or patients with symptoms that limit their ability to exercise. A small number of patients may experience flushing of the face and / or minor palpitations, both of which go away very quickly once the test is stopped. You may also notice symptoms that you would otherwise have developed during normal exercise, such as chest pain, breathlessness, or dizzy spells, which usually go away once the test is stopped.

Dobutamine (stress) echo is widely used in patients with suspected or existing coronary artery disease. There is a very small risk of serious side effects such as heart attack or stroke in these patients. Fortunately, serious side effects are very rare.

Please notify the doctor immediately if you are:

  • Pregnant or think that you may be pregnant (there is a risk of injury to the foetus from dobutamine)
  • Lactating or breastfeeding allergic or sensitive to medications or latex. Like any medical procedure, coronary angioplasty occasionally causes complications. However, in skilled hands these are rare. The doctor performing the investigation will discuss this with you before the test.