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About the test
A dobutamine stress test (stress echocardiography using dobutamine) is a non-invasive test (one that does not breach the body’s tissues) that involves monitoring heart function using an echocardiography machine as the workload on the heart changes. During the test, dobutamine is administered intravenously. This medicine increases the heart rate by increasing the volume of blood the heart pumps into the blood vessels in one minute. Stress echocardiography combines two-dimensional echocardiography (a heart echo) with an exercise electrocardiogram (an exercise ECG test), which is why it is often presented as an alternative to an exercise stress test.
Test description
Dobutamine stress echo involves monitoring heart function using echocardiography. An intravenous cannula is inserted before the test. During the test, the patient receives dobutamine intravenously, a medicine that increases the force of heart muscle contractions. Dobutamine produces a state in the body similar to that following physical exertion. The medicine is administered gradually, starting at a dose of 10 µg/kg/min, increased every 3 minutes by 10 µg/kg/min until a maximum dose of 40-50µg/kg/min is reached. This allows successive echocardiographic images of the heart to be recorded as the workload on the heart changes. The test is performed in an appropriately equipped examination room, under the constant supervision of the cardiologist performing it. The test takes approximately half an hour.
Purpose of the test
The purpose of a dobutamine stress test is to provoke a controlled shortage of oxygen in the heart muscle. It helps detect and assess the degree of heart muscle damage that may indicate coronary artery disease. The test identifies the presence and extent of myocardial ischaemia that develops in affected patients after dobutamine is administered. In patients who have had a heart attack, stress echocardiography is highly valuable for assessing the viability of a particular area of heart muscle and predicting the recovery of left ventricular contractile function in patients treated with primary angioplasty. A stress echocardiography test also helps determine whether a patient should undergo coronary angiography or a procedure on the heart if heart disease is suspected or has been diagnosed. It may also supplement the results of an exercise ECG test.
Indications for the test
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Suspected coronary artery disease in people unable to exercise
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An abnormal resting ECG that prevents assessment of ischaemia
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A negative or positive exercise ECG result that is inconsistent with the clinical picture
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Assessment of suitability for major non-cardiac surgery to evaluate the risk of cardiovascular complications
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Assessment of the functional significance of borderline lesions on coronary angiography.
Contraindications to the test
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Hypersensitivity to the medicine
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Conditions involving narrowing of the left ventricular outflow tract.
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Atrial fibrillation
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The acute phase of a heart attack
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Septic and cardiogenic shock with blood pressure below 80 mm Hg.
Preparing for the test
Before the test, the patient should consult a doctor to discuss the details of the test. Please note that beta-blockers reduce the effectiveness of dobutamine, so stopping these medicines on the day of the test is recommended. The medical history, including treatment to date, is also important information for the cardiologist performing the dobutamine stress echo.
Waiting for the result
The patient receives the result on the day of the dobutamine stress test. The cardiologist performing the test assesses and interprets it on site and discusses the findings with the patient.
Where and how can the test be performed?
Stress echocardiography using dobutamine is performed in many cities in Poland.
