Advice after your nerve block for surgery
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This information provides you with the information about your test so that you know what to expect. The medical staff can go into more detail, and answer questions on the day, as required.
If you have any questions before your test, please ring the Cardiac Bookings Office on
03006 133337.
The procedure takes place in the Cardiac Catheter Lab Department.
Please note that this is about 400 metres from the Main Entrance so please allow extra time to get here and for parking.
If you think you will not be able to walk this far then please use a wheelchair (there are some available in the Main Entrance) or ask at Reception for a Porter to take you.
What is a Dobutamine Stress Echocardiogram?
An echocardiogram (echo) is a routine ultrasound scan that uses sound waves (ultrasound) to produce real time images of your heart. You may have already had a routine transthoracic echocardiogram where a handheld probe is moved across your chest and the images are displayed on the echo machine screen. This gives information about various structures of the heart.
A Dobutamine Stress Echocardiogram (stress test) is similar but is performed while your heart rate is increased ‘stressed’ using medication called Dobutamine. It takes around one hour including recovery time.
Please note that this is not an ‘Exercise Test’ where you run on a treadmill.
What are the benefits of a Dobutamine Stress Echocardiogram?
It helps Doctor’s to identify if there is one or more areas of heart muscle that aren’t pumping as well under stress. If so, this could indicate a possible reduced blood supply to that area of the heart caused by a narrowing in one or more of the coronary arteries. It doesn’t look at the coronary arteries directly.
Preparing for the procedure - medication to stop before the test
If you take any of the following, please stop taking them 48 hours (2 days) before this test:
- Beta-blockers such as Bisoprolol, Atenolol, Propanolol, Nebivolol, Sotalol, Carvedilol, Metoprolol, Labetalol
- Ivabradine, diltiazem or verapamil.
These types of medication slow your heart rate and make it too difficult to perform the test. If you are unsure whether you take this medication, please consult your GP or pharmacist or call the Cardiac Bookings Office on 03006 133337.
Please bring a list of all your medication with you in case the Consultant needs to review it after the test. You can eat and drink as normal.
Before the Dobutamine Stress Echocardiogram
When you arrive at the Cardiac Catheter Lab please report to reception where the reception staff will check you in and ask you to take a seat in the waiting area. When the nurse is ready for you, they will call you through and prepare you for the procedure.
You will be asked to remove the clothes from your upper body and change into a hospital gown with the opening at the front. You will be weighed, and your blood pressure will be taken. A cannula is then inserted into your arm. Checks will also be made such as allergies, your understanding of the procedure and the stopping of relevant medication.
You then lie on a bed and three ECG leads are attached to your chest to monitor your heart rhythm during the scan. You will be asked to lie on your left side and the lights will be dimmed. You may also be asked to raise your left arm.
During the Dobutamine Stress Echocardiogram
Firstly, the Consultant will obtain a few images before the dobutamine stress echo begins. To obtain these images they will put a gel on your chest and press the ultrasound probe firmly against your chest.
You may need a contrast agent to help make the ultrasound pictures clearer. The contrast consists of micro bubbles and is safe for your kidneys. It will be administered through your cannula.
At the start of the stress test dobutamine is infused at a low dose, through your cannula, and you may not notice anything to begin with. The aim is to increase the dobutamine in stages until your heart rate has reached a planned target level. At each stage more ultrasound images are taken. We may need to give you an additional medicine called atropine, or ask you to squeeze a stress ball, to help reach your planned target heart rate.
Some people do not feel anything as the dobutamine is increased. However, some people feel a ‘prickly, tickly’ sensation in their head, feel hot and flushed and are aware of their heart beating more quickly and forcefully. These are all normal sensations of the test. Your blood pressure and heart rate will be monitored closely. Sometimes the ultrasound probe needs to be pressed firmly against your chest which may cause slight discomfort.
It is unlikely that you will feel any symptoms during the test but please tell us if you do experience any chest pain/discomfort, nausea, shortness of breath or any other symptoms. If necessary, the test can be stopped.
When your target heart rate has been achieved and all the images have been taken the medication will be stopped. Dobutamine is a very short acting medication which will be eliminated from your body within 15-20 minutes so your heart rate will come down quickly. If necessary, a medication called metoprolol can be given, through your cannula, to help slow your heart rate. Your heart rate and blood pressure will continue to be monitored.
After the Dobutamine Stress Echocardiogram
When your heart rate has returned to a satisfactory level, and you feel ok, your cannula will be removed, and you can get dressed. Most patients say that the test wasn’t as bad as they thought it was going to be.
You will be asked to take a seat back in the waiting area where you will be given something to drink. You will be advised how long you need to wait there for, usually between 15 – 30 minutes. After this, assuming you still feel well, you can go home.
There are no restrictions on what you can do after the test. Your results will be sent to the doctor who referred you.
Alternative Procedures
- Exercise Stress Echocardiogram where the heart is stressed with physical exercise. This can be quite physically demanding, so it is difficult if you have mobility issues or other physical limitations. In some cases, movement and heavy breathing can reduce image quality.
- Computed Tomography Coronary Angiography (CTCA) scan uses x-rays to take high quality three-dimensional cross-sectional images of the heart. This involves radiation albeit at a relatively small dose. It may be that you have already had a CTCA and following this have been referred for a dobutamine stress echocardiogram.
- Cardiac Magnetic Resonance Imaging (MRI) scan is a type of scan that uses strong magnetic fields and radio waves to produce detailed images of the inside of your heart. Having certain metallic implants can preclude having this scan.
- Myocardial Perfusion Imaging (MPI) uses a small amount of radioactive substance to assess blood flow to the heart muscle. It tends to be reserved for patients who cannot have the other alternative procedures.
Contact us
If you have any queries relating to this information, please contact the Cardiology service.
About this information
Service:
Cardiology
Reference:
C/020
Approval date:
1 August 2025
Review date:
1 August 2028
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Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.