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Dobutamine stress echocardiogram
Dobutamine stress echocardiogram (dobutamine echo, pharmacological echocardiogram): In this type of stress echo test, a medication called dobutamine is injected through an intravenous (IV) line. The medication stimulates the heart to respond as if you were exercising. The test is used to evaluate your heart and valve function when you are unable to exercise on a treadmill or stationary cycle. Echo is often combined with Doppler ultrasound and color Doppler to evaluate blood flow across the heart's valves.
To prepare:
- Do not eat or drink anything except water for four hours before the test. Do not drink or eat caffeine products (cola, Mountain Dew, chocolate, coffee, or tea) for 24 hours before the test. Caffeine will interfere with the results of the test.
- Ask your doctor what medications should be taken on the day of your test Your physician may ask you to stop taking some heart medications on the day of the test. He or she will give you specific instructions. If you have questions about your medications—ask your physician. Do not stop any medication without first talking with your doctor.
Your physician may also ask you to stop taking other heart medications on the day of the test. If you have questions about your medications—ask your physician. Do not stop any medication without first talking with your doctor.
Since many over-the counter medications contain caffeine (such as diet pills, NoDoz, 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 mediations that may contain caffeine.
If you have diabetes and take medications to manage your blood sugar, ask your physician how to adjust your medications the day of your test. 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.
You can wear whatever you like. You will need to change into a hospital gown to wear during the procedure.
What to expect:
Wires from 10 sticky electrodes on your chest will be attached to an EKG monitor to chart your heart's electrical activity during the test. An intravenous (IV) line will be inserted into a vein in your arm so the dobutamine can be delivered directly into your bloodstream. A cardiac sonographer will perform a resting EKG, measure your heart rate and take your blood pressure.
You will lie on your left side on an exam table so that a resting echo can be performed. The sonographer will place a wand (called a sound-wave transducer) on several areas of your chest. The wand will have a small amount of cool gel on the end to help get clearer pictures.
A physician or nurse will administer the dobutamine medication into the IV while the cardiac sonographer continues to obtain echo images. 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, lab personnel will ask how you are feeling and will check your EKG, blood pressure, and heart rate. The procedure is usually well tolerated, but occasionally there are complications. Lab personnel will watch for any symptoms or changes on the EKG monitor that suggest the test should be stopped. The IV will be removed once all of the medication has entered your bloodstream.
The dobutamine stress echo takes about 60 minutes. The actual infusion time is usually 15 minutes. You should plan to stay in the waiting room for at least 30 minutes after completing the procedure, or until all the symptoms you have experienced are resolved.
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