Dobutamine stress echocardiography

Dobutamine stress echocardiography is an ultrasound test which is performed to assess how the heart performs whilst under stress. Your Healthcare Professional may perform this test for a number of reasons but it is most commonly performed if you are being assessed for chest pain symptoms or if angina is suspected. The test is performed as an out-patient in the echocardiography department. If you are taking beta-blockers or calcium channel blockers (e.g. verapamil / diltiazem) then you will be asked to stop these 2 days beforehand.

When you arrive for the test you will be asked to remove your clothes from the waist up and will be given a gown to wear. There will usually be at least two members of staff in the room, a sonographer or doctor and another person who will monitor your heartbeat and blood pressure (usually a member of our nursing team) and administer medications. Next, three stickers will be placed on the shoulders/ chest and wires will attach to the ultrasound machine to monitor your heartbeat. A cuff will be placed on your arm and your blood pressure will be checked. A drip (cannula) will be placed in the arm so that medications and / or ultrasound contrast can be administered if necessary. Next you will be asked to lay down on a couch on your left side. The sonographer (healthcare professional performing the scan) will take some pictures of the heart whilst you are resting using a special ultrasound probe with gel. The probe will be placed in various positions on the chest to look at the heart from different angles. Often at this stage some ultrasound contrast (dye) is given via the drip. Once these pictures have been taken then medication known as dobutamine will be commenced which is given as a slow infusion via a drip. Further pictures of your heart will be taken at various stages throughout the test. When the dobutamine is being administered you may experience a sensation of your heart beating fast in your chest (palpitations) which is entirely normal. Some people also experience a dry mouth or flushing sensation. If you experience chest pain, shortness of breath or you feel faint / unwell you should tell a member of staff. Your blood pressure will be checked intermittently during the test and your heartbeat will be monitored throughout. If your heartbeat doesn’t reach the level required for an accurate test using the dobutamine medication alone we may also administer a medication known as atropine. Once your heart is working hard enough, the final pictures of the heart will be taken, and the dobutamine medication will be stopped. This medication is very short acting and your heartbeat will return to normal within a few minutes of the medication being stopped. Your blood pressure and heartbeat will be monitored until your heart has recovered, and you feel well. You will be asked to stay in the department for around 30 minutes after the test and if you feel well then you can leave after this. You will not usually get the results of the test before you leave as the sonographer must interpret these and issue a report. This report will be sent to your Healthcare Professional.

Dobutamine stress echocardiography usually a very safe and straightforward test and we perform thousands of tests every year at Wythenshawe Hospital. There is a small risk of an allergic reaction to the contrast dye (if used) which occurs in around 1 in 1000 people who are given the contrast dye. The dobutamine medication can occasionally cause a fast or irregular heartbeat, nausea, dizziness/fainting, high or low blood pressure and very rarely (around 1 in 10,000) a heart attack. If the medication called atropine is used then it can cause temporary blurring of vision and therefore you will be advised not to drive following the procedure.