Patients with coronary artery blockages may have minimal or no symptoms during rest. However, symptoms and signs of ischemic heart disease may be unmasked by exposing the heart to the stress of exercise. During test your symptoms, exercise tolerance, heart rate and blood pressure response to exercise ,electrocardiogram will be constantly monitored to see evidence of reduced blood supply (ischemia) which is often produced by a narrowed artery supplying blood to your heart muscle.

A resting echocardiogram will be done first. An Echocardiogram is an ultrasound-imaging scan of the heart using high frequency sound waves to see contractility of the heart muscle, all four chambers of the heart, the heart valves and the sac around the heart. While you lie on your left side with your left arm out, a small device called a transducer is held against your chest. A special gel is used to help the ultrasound waves get to your heart.

Following that most people will walk on a treadmill with an increasing speed and angle (about every 3 minutes). In most cases, you will be expected to walk for around 5 to 10 minutes, depending on your level of fitness and your age. Your doctor will ask you to stop: When your target heart rate is achieved. When you are too tired to continue If you are having chest pain /discomfort/short of breath/dizzy An unexpected change in your blood pressure (either too high or too low). If you are not able to exercise. Immediately after stopping the treadmill, you will be moved directly to the examination table.

The Echo examination will be immediately repeated. Your rest as well as post exercise images will be stored and then played back side by side in multiple views in the computer when your cardiologist analyzes them. The images will show whether any parts of the heart muscle fail to contract adequately when your heart rate increases. This is a sign that part of the heart may not be getting enough blood or oxygen because of narrowed or blocked arteries.

There are no known adverse effects from the ultrasound used during Echo imaging. The risk of the stress portion of the test is rare and similar to what you would expect from any strenuous form of exercise (jogging in your neighborhood, running up a flight of stairs, etc.). As noted earlier, experienced medical staff is in attendance to manage the rare complications like sustained abnormal heart rhythm, unrelieved chest pain or even a heart attack. These problems could potentially have occurred if the same patient performed an equivalent level of exercise at home or on a jogging track.