Stress Consent Form

What is the purpose of a cardiac ultrasound exam (echocardiogram)?

An echocardiogram is usually performed to assess the heart size and function and the structure and function of the heart valves.

An echocardiogram uses sound waves to create a visual image of the heart itself.  Sound waves are bounced off the heart by means of a small transducer placed on the chest.  As the sound bounces or echoes off the heart structures, they are translated into visual images on a screen monitor.  The images can reflect structural problems with the heart and its valves.  Echocardiograms are performed while you are lying on your left side, although you may be asked to switch positions frequently so that the technician can image your heart from a variety of angles.


Contrast Echocardiogram

A contrast echo is the same procedure as described above, but uses a contrast agent to help enable the technologist to better image the heart.  As the echocardiogram is performed, the technologist will see that the study is not as clear as it should be and will decide to use a contrast agent called Definity┬« to produce better images.  The Definity┬« is a liquid given in a vein and usually has no associated side effects.  The end result is a clear, quality image that will give your physician all the information he/she needs.


Bubble Echocardiogram

A bubble echocardiogram is an echocardiogram as described above using harmless saline bubbles.  After the initial ultrasound pictures are taken, an I.V. line is started in the arm.  A saline bubble solution is injected through the I.V. line while more images are taken.  This test is done most of the time to determine if there are abnormal blood flows or connections between the heart chambers.


How long will the test take?

The total amount of time this test will take is approximately 30 minutes.


Who administers the test?

An ultrasound technologist.


How should I prepare for my test?

There is no preparation necessary.


What is the purpose of a stress echocardiogram?

The stress echo is a diagnostic exam used to evaluate your level of fitness, your heart rate and blood pressure response to activity.  In conjunction with the exercise portion of the test, the echocardiogram portion will assess for the presence or absence of coronary artery disease.


Who administers the stress echocardiogram?

An ultrasound technologist performs the ultrasound and a certified exercise physiologist conducts the exercise portion of the test under the close supervision of the Cardiologist.


How long will the test take?

The total amount of time this test will take is approximately one hour.


How should I prepare for my test?

Avoid caffeine 12 hours prior to the test.

  • Bring a list of your current medications, including dosage and frequency.  Take your medications at your usual time, unless your physician has indicated otherwise.  You may take your medication with juice, milk or a piece of toast if necessary.
  • You may have water or juice before your stress test, but you should abstain from solid foods for at least two (2) hours prior to your test.  If you are a diabetic, please follow your normal daily diet regimen.
  • Wear comfortable clothes and shoes for your stress test. Slacks or shorts are preferred and shoes should be appropriate for brisk exercise on a treadmill.


What will I experience during the stress echocardiogram?

  • Prior to the test you will be asked to complete a personal history questionnaire. This questionnaire must be updated each time you have a stress test.  You will also be asked to read and sign a consent form.  This form provides information regarding the benefits and risks of the stress test.  Please do not hesitate to ask any questions you may have.
  • You will be connected to a heart monitor so that your heart rate and rhythm can be watched closely throughout the test.
  • A resting echocardiogram (ultrasound) will then be performed with specific attention to your heart muscle, valves and blood flow.
  • You will then exercise by walking on a treadmill.  You will start out slowly and then gradually increase in speed and incline.  Your heart rate and blood pressure will be monitored along with your EKG.
  • You will be encouraged to continually exercise throughout the stress exam.  If you experience any unusual symptoms at any time (such as chest pain, shortness of breath or lightheadedness) immediately tell the exercise physiologist monitoring the test. To increase the accuracy of the test, it is important to exercise as long as you can. Once you have reached a maximal effort level, the treadmill will stop and you will be asked to quickly lie down for another echocardiogram. You will then be monitored after the stress test until your heart rate, blood pressure and EKG return to resting levels.

For your convenience, download and print the consent form and bring it filled with you to save time.

Heart and Vein Center
18915 Twelve Mile Rd
Lathrup Village, MI 48076
Phone: 248-277-5205
Office Hours

Get in touch