Understanding Heart Disease
Your heart is responsible for pumping blood throughout your entire body.
The coronary arteries supply blood containing oxygen and other nutrients
to the heart muscle. However, these arteries can become blocked by the
accumulation of fatty substances (called lipids) This blockage is called
atherosclersosis or coronary artery disease (CAD). As CAD progresses,
the heart muscle may not receive enough blood, especially during times of
stress or physical activity. For some people, this will cause chest pain
(angina pectoris), breathlessness, and/or fatigue. For others, there may
be no symptoms to indicate that blood supply tot he heart is not sufficient.
However, if CAD goes undetected or untreated, there is the potential for
more serious complications to occur, such as a heart attack. But there
are risk factors that alert your doctor that you may be at risk for CAD.
Risk Factors for CAD
- Family history
- Overweight
- Lack of physical activity
- Smoking
- Poor diet and excessive intake of alcohol
- Presence of certain conditions (i.e., high blood pressure [hypertension], diabetes, high cholesterol, etc.)
- Hormone status (as women pass through menopause their risk of CAD increases)
- Increasing age
- Race
What is a Stress Echocardiogram?
A Stress echocardiogram, or stress echo, is an exercise test that is
combined with an ultrasound study of your heart. Using this test allows
your physician to see how well you heart pumps during increased activity.
A brief echocardiogram will first be performed while you are at rest. A
technician will then prepare you for your exercise test. One of our
physicians, as well, will be present for the exercise portion of the test.
Immediately after exercise, you will lay down on a bed and a second set of
ultrasound pictures will be recorded. By comparing the pictures taken
before exercise with the pictures taken after exercise, your physician
will be able to see any changes in your heart function while under the
stress of exercise.
Reasons Your Doctor May Want to Perform This Test
- If you have chronic chest pain or angina-images provide valuable information as to why you may be experiencing chest pain
- If you have recently experienced a heart attack-images can help your doctor visualize the extent of damage the heart underwent during the attack
- If you are about to undergo surgery - images can help the doctor see if your heart is strong enough to withstand the stresses of along and/or complicated surgical and anesthetic procedure
Preparation:
You may have a light breakfast 2 hours prior to the test. NO CAFFEINE,
NICOTINE OR ALCOHOL should be consumed 4 hours prior to the test.
Please wear comfortable, flat, walking shoes. TENNIS OR RUNNING SHOES
ARE PREFERRED. You should wear comfortable, loose fitting trousers or
slacks.
Your physician may ask you to withhold some of your medicines. Please
discuss this with your physician prior to the day of the test.
Report Any Symptoms
Be sure to tell the doctor if you feel any of the following during the test:
- Chest, arm, or jaw discomfort
- Irregular heartbeat
- Shortness of breath
- Nausea
- Headache
After Your Test
When the test is over, you may return to your normal routine. Ask your
doctor about taking any medication that you were told to skip before the
test.
Obtaining Your Test Results
The test results will be sent to your physician and will be discussed
wit you during a future office visit. The test results help the doctor
plan your treatment and any other tests that may be needed.
Dobutamine Stress Echocardiogram
What is an IV Dobutamine Stress Echocardiogram Test?
A dobutamine stress echocardiogram is an ultrasound study of the
heart combined with a pharmaceutical (drug-induced) stress test.
The test allows your physician to see how your heart functions when
it is required to work harder. This test is used to determine whether
there is clinically significant heart disease in individuals who are
unable to adequately exercise on a treadmill. The dobutamine stress
echo can show your physician if an area of the heart does not pump
properly due to an inadequate blood supply to the heart muscle.
Preparation
Check with your doctor regarding medications which you
take to see if you should take them before the test
Do not eat, smoke, drink alcohol, or have any caffeine
for 4 hours before the test
You may have liquids only the morning of your test
(water or juice)
Bring a list of all current medications you are on with
you on the test day
Arrange to have someone else drive you home after the test
Prior to your test
When you arrive in the Cardiology Department, you will be greeted by
a technician and asked to complete a medial history sheet and a consent
form.
The resting cardiac ultrasound images will be obtained at this time. The
technician will cleanse multiple areas on your chest and apply adhesive
patches (electrodes) to these areas. These electrodes will be connected
by wires to the EKG monitor to allow the technician to perform 12-lead
electrocardiograms during your test. Your blood pressure and EKG will
be monitored before, during and after your test.
An IV will be inserted in a vein. This needle will be used for the
dobutamine infusion. Dobutamine is a drug that produces an effect on the
heart that is similar to exercise.
The Time It Takes
Although the test takes less than 30 minutes, allow an extra hour for
checking in and getting ready for your test.
During Your Test
Small pads (electrodes) are placed on your chest to
record your heartbeat.
An intravenous (IV) line is started in your arm
A painless device (transducer) coated with cool gel is
moved firmly over your chest. This device creates sound
waves that make images of your heart.
Dobutamine is then slowly give through the IV. It is normal
to feel your heart pound for a few minutes.
Echo images are taken while you feel the effects of the
drug and after your pulse returns to normal.
You may be given a second drug to slow your heartbeat to
a normal level
Your heart and blood pressure are monitored during and after the test.
Report Any Symptoms
Be sure to tell the doctor if you feel any of the following during the test:
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· Chest, arm, or jaw discomfort
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· Irregular heartbeat
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· Feeling flushed
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·Shortness of breath
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· Nausea
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· Headache
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After Your Test
When the test is over, you may return to your normal routine. Ask your
doctor about taking any medication that you were told to skip before the
test.
Obtaining Your Test Results
The test results will be sent to your physician and will be discussed
wit you during a future office visit. The test results help the doctor
plan your treatment and any other tests that may be needed.
