DOBUTAMINE STRESS ECHO (DSE)

WHAT IS A DOBUTAMINE STRESS ECHO (DSE)?

Dobutamine stress echo combines echocardiography which is an ultrasound of your heart and a stress test wherein the stress is triggered by an injection called dobutamine.

The purpose of the test is to compare the images of the heart muscle before and after it is stressed. In a healthy heart, all areas of the heart pump harder during exercise. Abnormal movement of the heart may mean there is a blockage in the artery that supplies blood to that area. Abnormal heart wall motion may be seen at rest if there was a previous heart attack. If an artery is only partially blocked and there has not been any heart damage, the motion of the heart is usually normal at rest but may be temporarily abnormal during or immediately after dobutamine injection.

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who needs a dse?

Since a stress echo combines both the ECG recording and echocardiographic assessment, it provides more valuable information in identifying the possibility of blocks in the heart vessels. Patient with previous heart attack, angioplasty or bypass surgery, with baseline ECG abnormalities who are experiencing cardiac symptoms are advised a DSE.
Patients who cannot perform exercise and needs a stress evaluation like patients undergoing knee replacement surgery or
Patient with valve disease like aortic stenosis and poor heart function to understand severity of disease

what happens during a DSE?

After you have signed a consent form, stickers (called electrodes) will be put onto your chest to monitor your heart rate and rhythm. Blood pressure will be taken at rest. A canula will be inserted into a vein on your hand.
You will lie on the bed and an echocardiogram will be performed using a transducer coated with the conductive gel to record the images of your heart at rest.
Dobutamine injection will be administered into your vein as an infusion at increasing doses depending on your body weight. During this time, your heart rhythm, heart rate and blood pressure will be monitored at each stage of dose escalation. Echo images will be recorded at low doses.
Once the target heart rate is reached, an echocardiogram will again be performed to record images of the heart under stress and the infusion will be stopped. Echo images will also be taken after recovery of heart rates. The test takes around 1-1.5 hrs to complete.
At times, an ultasound contrast may be injected into the arm vein for better imaging of the heart.
When the test is complete, we will continue to monitor your heart rate and blood pressure as it returns to baseline.

how to prepare for a DSE?

Please be accompanied by a relative when coming for the study
Do not eat or drink (except water) for 3 hours prior to the test.
Exercise or physical labour should be avoid for 24 hours prior. On the day you should come in well rested.
Shaving of the chest in male patients is required before coming.
Continue to take all of your usual medications, unless advised and bring a list of your current medications with you to the clinic.
Patients taking beta blockers are advised to discontinue them for 48 hrs prior to the test

are there any risks?

The risk of a serious complication is extremely low. The risk can include symptoms like chest pain, high blood pressure, irregular heartbeats, dizziness or very rarely a heart attack or sudden cardiac arrest. You will carefully monitored to prevent these and react quickly if they occur.