The physician will give the patient specific pre-test directions to follow, but patients are often given common guidelines, such as:
- Patients should not eat, drink, or smoke for four hours before stress echocardiography, but should take any medications as usual unless otherwise directed, and
- Patients receiving transesophageal echocardiography should not eat after midnight the night before the test, but should take any medications as usual.
Echocardiography is performed by a trained sonographer or technician at an echocardiography lab, a clinic, or in the patient's hospital room. Throughout the test, an electrocardiogram, or ECG, which record's the heart's electrical activity, is performed to monitor the heartbeat and blood pressure is monitored. For transthoracic and stress echocardiography, a gel is used on the chest to improve conduction and reception, it may feel cold and moist. The transducer is moved across the chest to gather data and the patient may feel slight pressure surrounding the area being examined. The patient may hear a 'whooshing' sound, which is the amplified sound of the blood flowing.
For transesophageal echocardiography, a sedative will be administered. For a transesophageal echocardiogram, the patient swallows a long, slender, flexible tube that has an ultrasound-imaging device near its tip. The tube is directed from the mouth, through the esophagus, and into the stomach.
For stress echocardiography, the patient exercises on a treadmill or stationary bicycle until reaching a pre-determined target heart rate, then stops exercising and the transthoracic echocardiographic technique is used.
Occasionally, the patient may be asked remain silent or hold his or her breath so that the heart may be seen more clearly.
The procedure lasts approximately 30 to 60 minutes.