Dobutamine Stress Echocardiography

What to Expect

During the Procedure

• Description of the room, monitoring devices, positions, and equipment that will be used - The procedure is performed in a room large enough to hold an EKG machine, an echo machine, an IV pump, and a blood pressure monitor. The equipment used includes an EKG machine, an echo machine, an IV pump, skin electrodes, and lead wires that attach to the skin electrodes. A blood pressure cuff attached to an electronic monitoring machine is used. You will have initial, or "baseline," EKG, echo, and blood pressure readings done while you are lying on a table or bed prior to the dobutamine infusion.
  
  
• Anesthesia - None required.
  
  
• Basic description of the procedure:
  
  
  • The technician will ask you to remove your clothing from the waist up. Your privacy will be maintained by drapes across your chest and by limiting access into the procedure area.
    
    
  • You will lie on your left side on a table or bed, but may be asked to change position during the procedure.
    
    
  • EKG leads will be attached to your chest, so that the echo images can be compared to the EKG tracing.
    
    
  • An IV line will be started in your hand or arm.
    
    
  • A blood pressure cuff will be placed on your arm.
    
    
  • A baseline assessment of your heart rate and blood pressure will be done.
    
    
  • The technician will place warmed gel on your chest and then place the transducer probe on the gel. You will feel a slight pressure as the technician positions the transducer to get the desired image of your heart.
    
    
  • The dobutamine infusion will begin at a rate determined by your weight. The rate of the infusion will be increased every 3 minutes until you have reached your target heart rate (determined by the physician based on your age and physical condition), or until the maximum dose of dobutamine has been reached.
    
    
  • After the dobutamine is started and after each increase in the dobutamine rate, your blood pressure will be checked, an EKG tracing will be performed, and echo images will be obtained. The technician will move the transducer around on your chest so that all areas and structures of your heart can be observed. During the test, the different echo techniques described above (M-mode, 2-D, Doppler, and color Doppler) may be used. You will not be aware of the different techniques except that during the Doppler or color Doppler, you may hear a "whoosh-whoosh" sound. This whooshing sound is your blood moving through the heart.
    
    
  • Once your have reached your target heart rate or the maximum amount of the dobutamine, the medication will be stopped. Your heart rate, blood pressure, EKG, and echo will continue to be monitored for 10 to 15 minutes until they have returned to the baseline state, or close to it.
    
    
  • Once all the images have been taken, the technician will wipe the gel from your chest, remove the EKG electrode pads and take out the IV line.
    
    
  • When the procedure is completed, you may then put on your clothes. You may leave unless instructed otherwise by your physician.
    
    
• Procedure time - The test normally takes approximately 45 to 60 minutes, depending on how many different techniques are used and the quality of the images. However, events such as schedule delays, emergencies, and other factors may delay the start of your procedure, or prolong the length of it.

After the Procedure

• Recovery - There is normally no recovery necessary after this procedure.
  
  
• Length of stay - No hospital stay is necessary, unless your physician determines that your condition requires further observation or hospital admission.
  
  
• Recuperation time - None.
  
  
• Outcome - If the echo is normal, your physician may begin to look for other non-cardiac causes for any symptoms you may have had. If the echo is abnormal, indicating the existence of coronary artery disease, or other heart disease, your physician may wish to conduct further testing, such as an MRI, or a cardiac catheterization.
  

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