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Preventive Cardiology Clinic

Stress Echocardiogram

An echocardiogram is a painless, harmless test that uses high frequency sound waves (ultrasound) to display a moving image of your heart onto a video screen in order to examine the heart's anatomy and function.

The stress test evaluates your heart's response to physical activity through the monitoring of heart rate, blood pressure, and electrocardiograms while you exercise on a treadmill. 

A exercise treadmill stress echocardiogram, commonly referred to as a stress echo, is a combination of a stress test and an echocardiogram. This is an excellent test for not only detecting significant coronary artery disease but to also evaluate the size, function, and structures of your heart. There are many questions that a stress echo can answer such as:


  • The presence of significant coronary artery disease

  • Blood pressure response to exercise

  • Abnormalities with your heart's electrical activity

  • Fitness level

  • Heart size

  • Systolic (squeezing) and diastolic (filling) function

  • Structural heart abnormalities (heart valves and chambers)

  • Aortic size



Unlike a plain stress test there is imaging involved with a stress echo, which increases accuracy. Because of this a stress echo is a more commonly ordered test for detecting significant coronary artery disease and is typically performed on someone who is:


  • Having chest pain which is suspicious for coronary artery disease

  • Having shortness of breath more than what is expected with exercise

  • Having palpitations

  • Placed in a medium to high pre-test risk category for having significant coronary artery disease, this includes:

    • Strong family history of heart disease

    • Abnormal cholesterol and triglyceride levels

    • Abnormal resting electrocardiogram

  • Older males and females of any age

A stress echo is a very safe test to perform. The risk of having a serious complication (heart attack or death) is less than 1 in 10,000. Keep in mind that you will be continuously monitored throughout the test by experienced personnel and the test will be stopped if there is any indication that continuing would be unsafe.

Stress Echo Details & Preparation

A stress test is the perfect opportunity to push yourself beyond your normal exercise tolerance and see what you are capable of doing. The longer you can stay on the treadmill the more information that is gathered which will result in you having more confidence in your heart's health.

Preparing for the test 
  • DO NOT eat, drink, or smoke for at least three hours before the test.

  • DO take your usual medications with a sip of water unless instructed otherwise br your provider. Diabetics who use insulin or glucose lowering agents may need to adjust their dosage. Please check with your provider if you are not sure.

  • DO wear comfortable clothes and walking shoes.


Stress test details
  • Plan on the test taking 1 hour to complete.

  • You will be asked to disrobe from the waist up, if you are female you will be given a gown to wear.

  • 10 EKG electrodes will be placed on your chest wall. For men, limited shaving of the chest may be necessary to assure good contact between your skin and the electrodes.

  • Blood pressures and EKGs will be taken before, during, and after the stress test.

  • Your treadmill exercise will follow a standard protocol, every 3 minutes the speed and elevation of the treadmill will increase. Your pace will start at a slow walk and end with a brisk walk or slow jog depending on your fitness level

  • Average exercise time on the treadmill is 6 - 12 minutes.

  • The test will end if any of the following are met:

    • If you are unable to keep pace with the treadmill.

    • If you experience dizziness or lightheadness.

    • Abnormal EKG changes or blood pressure readings.

    • Maximum target heartrate is achieved.

The stress test will be interpreted by Dr. Klodas, the final report will be delivered to the appropriate person within 5 - 7 business days.

Click on the video below to see a demonstration of a stress echocardiogram.

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