Dobutamine Stress Echocardiogram

It is a non-invasive stress investigation that involves the use of echocardiogram for individuals who are unable to exercise adequately on the treadmill. Instead of exercising on the treadmill, dobutamine will be given to you intravenously to make your heart pump as hard as if you were exercising.

An echocardiogram is a non-invasive imaging technique that enables your cardiologist to visualize how your heart pumps. It makes use of sound waves to produce moving images of your heart while it pumps blood around your body.

Dobutamine stress echocardiogram procedure

Before the test, the cardiac sonographer will spread gel and applies sticky patches (electrodes) on your chest wall. The sonographer will then apply a device (known as a transducer) on the gel, aiming an ultrasound beam against your heart at different angles in order to obtain a collective set of moving images of your heart produced by the computer. The moving images will be displayed on the monitor which you can see “live”.

Is it necessary for me to do a Dobutamine Stress echocardiogram?

  • After weighing the risks and benefits of this procedure, your Cardiologist would have determined on the basis of your condition that it is more beneficial for you to undergo this procedure.
  • This test is necessary to evaluate the function of your heart and valves while it undergoes “stress”. Your Cardiologist will be able to assess how your heart pumps and how your heart valves function while your heart exercises under the influence of dobutamine infusion.
  • Your Cardiologist can also assess the possibility you having any significant coronary artery disease (narrowed or blocked arteries).

How is the investigation carried out?

  • The echo will be performed by a very experienced cardiac sonographer, and occasionally by your cardiologist if certain images are needed.
  • You will be asked to undress from the waist up, lie on the examining couch on your side (typically on your left).
  • Transducer gel and sticky patches (electrodes) will be applied on your chest. The electrodes will be attached to the cables linked to the ECG machine. You will also wear a blood pressure cuff around your arm
  • The cardiac nurse will insert an intravenous cannula (drip) into one of your veins. This is to allow Dobutamine medication to be given to you during the test.
  • Images of your heart will be taken before your heart exercises (resting images).
  • During the investigation, the lights will be dimmed, and your cardiac sonographer will press the transducer against your chest to obtain the relevant images.
  • The transducer may be pressed firmly against your chest wall (which may be uncomfortable at times), and you may be asked to take and hold your breath in order for your sonographer to obtain the best images.
  • Dobutamine medication infusion will begin to be infused to you via the drip line. You will feel your heart beat faster or racing during the test which is normal response. If you feel any chest pain, shortness of breath or any discomfort, please inform your Cardiac Sonographer or Cardiac nurse. The test may be terminated if necessary. Your heart rhythm, blood pressure and heart rate will be monitored closely throughout the procedure.
  • Once your heart rate achieves the desired target, and adequate optimal images are taken, your Cardiac Sonographer will stop the test. Occasionally, another medication (Atropine) may be given to increase your heart rate if Dobutamine is inadequate.

Are there any risks involved?

There are no known risks associated with echocardiogram. However, Dobutamine may be associated with irregular heart rhythm, high blood pressure, low blood pressure or chest pain. Serious complications such as heart attack and life-threatening heart rhythms are rare.