Explanation of the tests
Your doctor has requested that you have a stress echocardiogram. This test is often used to investigate symptoms such as chest discomfort or breathlessness, and in people with known or suspected heart disease. There are two parts to this test:
In the first part a cardiac scientist performs an echocardiogram, (ultrasound of the heart). To ensure good contact between your skin and the probe, ultrasound jelly is placed at several different sites on your chest.
In the second part of the test, your heart is exercised or ‘stressed’ by walking on the treadmill. The speed and slope of the treadmill will increase every few minutes, to make your heart work harder. When your heart is working as hard as possible, you stop exercising and quickly lie down on the bed. More echocardiogram pictures are taken. Your heartbeat will be monitored throughout exercise and for after exercise is stopped.
Risks and discomforts
There are risks and complications with this investigation. They include but are not limited to:
Common risks and complications (more than 5%)
Rare risks and complications (less than 1%)
Abnormal heartbeat – this usually settles without treatment.
Build-up of fluid in the lungs. You may need medication to treat this.
Chest pain. This may be treated with medications.
Heart attack.
Death as a result of this procedure is extremely rare. (1-2 people per 10,000 tests).
If any complications arise during the test they will be treated immediately.
Inquiries
If you have any questions please discuss them with the doctor before signing this form. Any questions about the procedures used in the exercise stress test are welcome. If you have any doubts or questions, please ask us for further explanations.
Freedom of consent
Your participation in this exercise test is voluntary. You are free to deny consent if you so desire. I understand the test procedures that I will perform and I consent to participate in this test. I do hereby give my consent to the Doctor to administer the treatment and test referred to above. If at any time during the test I have discomfort or pain, I will tell the testing physician or technologist in charge.
