What is it?
Your Doctor has ordered a Dobutamine stress echo. This test utilizes the drug
Dobutamine to simulate the heart without the need for physical exertion and is
particularly useful in patients who are unable to exercise to a level that accurately
excludes problems with the heart arteries. This may be useful in patients
with arthritis or poor circulation in the legs. The initial echocardiogram uses
painless ultrasound to examine the function of the heart muscle and heart
valves. A drip is then inserted in your arm to allow the infusion of Dobutamine,
which makes the heart beat faster and stronger, consuming more oxygen and
highlighting areas of inadequate blood supply. During this time, you may feel
your heart beating forcefully but this is normal. The initial echo scan takes 45
minutes and is followed by a period of drug infusion lasting usually 10 – 15 minutes.
Following this a repeat scan is performed that takes 20 minutes During
the test we will watch your heart rate and blood pressure and will want you to
tell us of any symptoms such as chest pain, dizziness or shortness of breath.

What preparation do I need?
It is preferable to not eat for at least 4 hours before the test.
Medications: Check with your Doctor. We usually stop beta blockers
(Tenormin, Betaloc, Noten, Lopressor, Visken, Inderal, Atenelol) and Calcium
blockers (Isoptin, Cordilox, Veracaps, Cardizem) for 24-48 hours before the
test.

What are the risks?
Dobutamine stress echos have an excellent accuracy of detecting problems
with the heart arteries of between 90 and 95%. However, in occasional patients
they may fail to detect actual heart problems. If your chest pain persists despite
a satisfactory exercise test you should notify your Doctor who may then order
more extensive testing. Dobutamine is a drug that is often used to treat patients
with heart disease and therefore the risk of a Dobutamine stress echo is low.
Your blood pressure and heart rhythm is continually monitored. Rarely, in patients
with very severe heart disease (and with other forms of stress testing) it
can precipitate a heart attacks or cardiac arrest. You should notify us if your
chest pains have been worsening or become more frequent in the days
leading up to the test. We have full facilities to deal with cardiac emergencies
and the backup of the hospital and Coronary Care Unit if required.

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