Dobutamine Stress Echocardiogram

Common reasons for ordering a DSE include:

• To assess the heart’s overall pumping function.
• To assess the degree of known heart valve disease.
• To evaluate your cardiac health prior to surgery.

There may be other reasons for your doctor to recommend a DSE.

Possible risks associated with a DSE include:

• Chest pain
• High blood pressure
• Arrythmia
• Dizziness
• Headache
• Nausea
• Extreme tiredness
• Heart attack (rare)

There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your healthcare provider before the test.

Certain factors or conditions may interfere with a DSE such as:

• Ingesting caffeine within 3 hours of the test.
• Prescription medication to control your heartrate. Please check with your doctor if you should continue your medication as prescribed on the day of the test.

• You will be asked to sign a consent form that gives your permission to do the test. Read the form carefully and ask questions if anything is not clear.
• Tell the stress tech or doctor if you are allergic to or sensitive to any medicines or latex.
• Caffeinated beverages, such as coffee, tea and soda, should not be consumed for 3 hours prior to testing.
• Tell your doctor of all medicines (prescription and over-the-counter), vitamins, herbs and supplements that you are taking.
• You may be instructed to hold certain medicines before the test, such as beta-blockers. Your doctor will give you specific instructions.
• Tell your doctor if you are pregnant or think you could be.
• Tell your doctor if you have a pacemaker.
• Based on your medical condition, your doctor may request other specific preparation.

A DSE may be done on an outpatient basis or as part of your hospital stay. Steps may vary depending on your condition and your doctor's practices.

Generally, a DSE follows this process:

1. You will be asked to remove any jewelry or other objects that may interfere with the test. You may wear your glasses, dentures or hearing aids if you use any of these.
2. You will be asked to remove clothing from the waist up and will be given a gown to wear.
3. You will be asked to empty your bladder before the test.
4. An intravenous (IV) line will be started in your hand or arm before the test. It’s needed for injection of the dobutamine and to give you IV fluids, if needed.
5. You will lie on your left side on a table or bed, but may be asked to change position during the test.
6. You will be connected to an electrocardiogram (ECG) monitor that records the electrical activity of your heart and monitors your heart during the test using small electrodes that stick to your skin. Your vital signs (heart rate, blood pressure and breathing rate) will be monitored during the test.
7. The room will be darkened so that the images on the echo monitor can be seen by the technologist.
8. The cardiac sonographer, who performs the echo portion of the test, will place gel and a transducer on your chest. (To find out more about what an echo is, click here.) You will have images of your heart acquired before, during and after the Dobutamine injection.
9. A cardiologist will begin the Dobutamine infusion at a rate determined by your height and weight. The rate of the infusion will be increased every few minutes until you have reached your target heart rate (determined by the doctor based on your age and physical condition), or until the maximum dose of Dobutamine has been reached.
10. After the Dobutamine is started and after each increase in the Dobutamine, your blood pressure will be checked, your continuous ECG tracing will be monitored and echocardiogram images will be recorded.
11. Once you have reached your target heart rate or the maximum amount of the Dobutamine, the medicine will be stopped. If your heartrate fails to reach the maximum level, additional medication may be given. The cardiologist will explain this to you if this is needed.
12. Your heart rate, blood pressure and ECG will continue to be monitored for 10 to 15 minutes until they have returned to the baseline state. Final echocardiogram pictures will be taken.
13. Tell the cardiologist if you feel any chest pain, trouble breathing, sweating or heart palpitations at any time during the test.
14. Once all the images have been taken, the cardiac tech will wipe the gel from your chest, remove the ECG pads and take out the IV line. You may then put on your clothes.

You may go back your usual diet and activities unless the cardiologist or your ordering doctor instructs you differently.

The results of your test will be ready for your ordering doctor to view within your electronic health record by the end of the day you had your test. You should follow up with your doctor to get the results.