A stress echocardiogram combines two well-established cardiac tests — an echocardiogram and a stress test — to give your cardiologist a detailed picture of how your heart performs under physical demand. At rest, a technician will use ultrasound to capture images of your heart’s chambers and valves as they move. You’ll then exercise on a treadmill, and immediately at peak effort, further ultrasound images are taken. By comparing the resting and exercise images side by side, your cardiologist can identify areas of heart muscle that don’t receive enough blood flow during exertion — a finding that wouldn’t be visible if you were simply lying still.
The main purpose of a stress echocardiogram is to look for evidence of coronary artery disease, where narrowed or blocked arteries reduce blood supply to part of the heart muscle during exercise. When blood flow is restricted, the affected segment of heart muscle moves less vigorously than the surrounding tissue — a pattern your cardiologist can identify directly on the ultrasound images. The test is more sensitive than a standard exercise ECG alone and is also valuable for assessing how heart valve problems, particularly aortic stenosis and mitral regurgitation, behave with exertion. If you are unable to exercise sufficiently, the same information can sometimes be obtained using a medication that temporarily mimics the effect of exercise on the heart. The test usually takes around 45 to 60 minutes and carries no radiation exposure.