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Exercise Stress Echocardiogram

Date issued: June 2016

For review: June 2018

Ref: B-238/Cardio/LZ/Exercise stress echo v2

PDF:  Exercise Stress Echocardiogram [pdf] 158KB


Your Doctor has decided that you should have an Exercise Stress Echocardiogram


What is it?

  • An echocardiogram or ‘echo’ is a scan that uses ultrasound (sound waves) to produce pictures of the heart.  The test is painless and does not use radioactivity.
  • During an Exercise Echo, your Doctor will ask you to pedal on an exercise bike whilst pictures are taken of your heart.


Why is it being done?

  • An Exercise Echo is performed as it allows your Doctor to understand how the heart copes when it is made to work harder.
  • An Exercise Echo is useful to diagnose whether you have angina or not.  It can also give your Doctor information about the severity of a heart-valve problem.


What does it involve?

  • You will be taken into a darkened room, three people will usually be present when you have the test, a Doctor, a cardiac  physiologist/Sonographer and an assistant nurse.
  • You will be asked to undress to the waist and put on a gown that should be left open to the front. You will be asked to make yourself comfortable on the exercise bike.
  • Stickers will be attached to your chest and connected to the machine, additional stickers will be attached to your chest to perform an ECG which will be monitored during the test.

Your blood pressure will also be checked regularly throughout the test.  A drip may be placed in the vein in your arm, if the doctor needs to inject contrast which improves the quality of the images recorded.

The images will then be stored on a database which is only accessed by selected NHS personnel responsible for your care.

Please note: If you do not wish to have your information stored on the database the only way we can comply with this request is not to perform the echo.


  • Pictures of your heart will be recorded on the machine.  You will then be asked to exercise by pedalling an exercise bike.  The exercise will be gentle at first but will get progressively more strenuous.  Occasionally the Cardiac Physiologist/Sonographer may record pictures of your heart whilst you are exercising.
  • When the Doctor has decided that you have performed enough exercise, or if you are unable to continue, the Doctor will ask you to lie still and more images of the heart will be recorded.


You will continue to have your heart rate and blood pressure monitored until you have fully recovered, which may take several minutes. 


  • Overall the Exercise Echo will take around 45 minutes to an hour to complete.


Are there any special precautions that I need to take before the Exercise Echo?

You must NOT take beta-blocker or calcium-channel blocker tablets for 48 hours before the test (unless otherwise instructed by the Doctor).


Beta-blocker tablets include Atenolol, Bisoprolol and Carvedilol, although there are others.  Calcium-channel blockers are called Diltiazem and Verapamil.  These tablets prevent the heart from working hard.  If you do continue with beta-blocker or calcium-channel blocker drugs, the Exercise Echo may need to be postponed.  If you have any doubts, please contact your Doctors’ secretary or this unit. 


  • You should continue other medications as usual. 
  • If you use a nitrate spray (GTN) under your tongue, please bring this with you.

At the end of your echocardiogram

You will be able to return home after the test has been completed.  You may undertake your day-to-day activities as usual. 


Are there any risks in having the Exercise Echo?

  • The Exercise Echo scan is extremely safe as it is just like exercising as if you were at home. 
  • There is an extremely small risk (less than 1 in 10,000) of developing an allergic reaction if contrast is used.  If you have had allergic reactions to any medicines before please inform your Doctor before starting the test. 
  • If you suffer with angina, there is an extremely small risk (less than 1 in 10,000) you may have a small heart attack during the test.



This document has been adapted from the British Society of Echocardiography

Date: May 2012

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