Pharmacological Stress Echocardiogram (Echo)

This leaflet tells you about a Pharmacological Stress Echocardiogram (Echo) and what to expect if you are invited for an appointment to have this test performed.

What is a pharmacological stress echo?

An Echocardiogram or Echo is an ultrasound scan of your heart. This means that a hand-held scanner, connected to a large machine on wheels, is held over your chest and uses sound waves to take pictures of the inside of your body.

The procedure does not cause any pain, but you might feel some pressure and be slightly uncomfortable when the scanner is on your skin. You will have a cannula (a small tube) inserted into your vein by needle to give you a drug during the test.

This test will be done by an Echocardiographer, who is someone trained to do this specific test.

Why have I been asked to have this test?

It is used to:

• Diagnose if you have angina or not.
• Give your doctor information about how severe a valve problem is.
• Help your doctor to decide what further treatment you may need.

What will happen during my procedure?

You will be asked to undress to the waist and put on a gown, which needs to be left open at the front. You will lie on a bed on your left hand side.

The Echocardiographer will put gel on your chest, which might be a little cold, and will then roll the ultrasound probe over the area.

This will show a picture of your heart on the monitor of the ultrasound machine. The images are recorded, and the cardiac team can check the condition of your heart.

The rhythm, rate and electrical activity of your heart will be monitored. Small electrodes (sticky pads with sensors) are put on your chest and leads (wires) are attached to them. These leads connect to a machine to record your heart beating.

During the test you will also have an injection into your vein. This is why you have a cannula inserted before the test begins.

The injection will make your heart beat harder and faster, which can sometimes be uncomfortable, but means it is easier to see how your heart is working.

A doctor will be in the room to make sure everything is ok during the test. They will check your blood pressure and pulse and ask you some questions to check on you.

How long will the procedure take?

The procedure usually takes about 30 minutes to complete. You can expect to be in the unit for no more than 1 hour.

Where will I need to go?

You will be given an appointment to attend the Cardiac Investigations Unit at North Tees Hospital. This is located in corridor 1 on the ground floor of the Hospital.

Can I take my medications as usual?

You must not take beta-blocker or calcium-channel blocker tablets for 48 hours before the test. Beta-blocker tablets include Atenolol, Bisoprolol and Carvedilol, although there are others. Calcium-channel blockers are called Diltiazem and Verapamil.

These tablets prevent the stress medicine from making your heart work harder. If you do continue with beta-blocker or calcium-channel blocker drugs, the test may need to be postponed.

If you have any worries or concerns, see the contact numbers at the end of this leaflet.

You should continue any other medications as usual.

What are the risks and possible complications?

A Pharmacological Stress Echo scan is extremely safe, but there are some risks you need to be aware of:

• Most people will feel some flushing in the face and scalp (top of your head). This is the medication working and opening up blood vessels.

• Severe heart rhythm problems can sometimes happen. This happens in about 1 in 700 people, but can be managed with another medication. Very rarely (1 person in every 10,000) this can cause death.

• 1 in every 100 people might have a mild change to their heart rhythm during this test. This is usually settled with medication after the test and generally only lasts a few minutes.

• 1 in every 5000 people can experience some angina, or possibly have a heart attack during this test. If this happens the team will give you treatment, and might recommend you stay in hospital overnight for observation.

• You might need to be given a medication called ‘contrast’ which helps with the image quality. This medication can cause an allergic reaction in 1 out of every 10,000 people. However, if this reaction happens medicine to reverse the reaction can be given which is very effective. You might need to stay in hospital for observation but this is rare.

You will be monitored during and after the test. The staff are trained to react to any complication if needed.

What will happen after my stress echo?

After the test, you may be asked to sit quietly for about 20 minutes.

This is to make sure the effects of the stress medicine have completely worn off.

You will be able to go home after this if you feel well enough.

Can I drive home after my procedure?

Depending on the type of medication you are given during the test it is possible that you may be unable to drive safely for a few hours afterwards. To allow for this possibility you should arrange for someone to take you home following the test.

If you have the ‘atropine’ medication, it can make your vision blurred and you cannot drive or operate machinery until the following day. You will be told by the team if this is the case.

When will I be told the results of my scan?

The team might be able to give you the results straight away after the scan. Sometimes, the scan may need to be looked at in more detail or discussed at a multi-disciplinary meeting.

In these cases, the Doctor or Specialist Nurse who requested the stress test will contact you later to update you. This may be via letter or a clinic appointment.

Contact numbers

If you have any worries or concerns please contact:

University Hospital of North Tees

Cardiac Investigation Unit
Telephone: 01642 624500
Monday to Friday, 9.00am to 5.00pm

Further information:

NHS 111
Telephone: 111 (when it is less urgent than 999)
Calls to this number are free from landlines and mobile phones or via the website at www.nhs.uk

CComments, concerns, compliments or complaints

Patient Experience Team (PET)

We are continually trying to improve the services we provide. We want to know what we’re doing well or if there’s anything which we can improve, that’s why the Patient Experience Team (PET) is here to help. Our Team is here to try to resolve your concerns. The office is based at the University Hospital of North Tees if you wish to discuss concerns in person. Our contact details are:

Telephone: 01642 624719
Freephone: 0800 092 0084
Opening hours: Monday to Friday, 9:30am to 4:00pm
Email: [email protected]

Out of hours

Out of hours if you wish to speak to a senior member of Trust staff, please contact the hospital switchboard who will bleep the appropriate person.
Telephone: 01642 617617

Patient, Public and People with Lived Experience

We are looking for patients to share their experiences of healthcare and to join our Involvement Bank. Working with the patients, carers, families and the general population we support in making decisions about their care can lead to better health outcomes, increased patient satisfaction and a better overall experience. We want to listen and work with you in shaping the future of your healthcare services. To find out more about the Involvement Bank go to our website or contact us at:

Website: www.nth.nhs.uk/about/community/people-with-lived-experience
Email: [email protected]

Data protection and use of patient information

The Trust has developed Data Protection policies in accordance with Data Protection Legislation (UK General Data Protection Regulations and Data Protection Act 2018) and the Freedom of Information Act 2000. All of our staff respect these policies and confidentiality is adhered to at all times. If you require further information on how we process your information please see our Privacy Notices.

Telephone: 01642 383551

Email: [email protected]Privacy Notices

Leaflet feedback

This leaflet has been produced in partnership with patients and carers. All patient leaflets are regularly reviewed, and any suggestions you have as to how it may be improved are extremely valuable. Please write to the Clinical Governance team at:

Email: [email protected]