Download Dobutamine Stress Echocardiogram

Dobutamine Stress
Echocardiogram
Turnberg Building
Cardiology
0161 206 2031
© G15121005W. Design Services, Salford Royal NHS Foundation Trust, All Rights Reserved 2015.
Document for issue as handout. Unique Identifier: CS81(15). Review date: December 2017
Rate control drugs that must be stopped 2 days
(48 hours) before the test
Beta Blockers
(Stop 3 days (72 hours) prior to test if you are a dialysis patient)
Atenolol
(Tenormin, Co-tenidone, Tenoret)
Bisoprolol
(Cardicor, Emcor)
Carvedilol(Eurcardic)
Acebutelol(Sectral)
Nebivolol (Nebilet)
Metoprolol(Lopresor)
Propranolol (Inderal, Half Inderal)
Nadalol(Corguard)
Oxprenolol (Trasicor, Trasidrex)
Sotalol
(Sotacor, Beta-Cardone)
Calcium Channel Blockers
Verapamil
(Securon, Univer, Cordilax, Vertab, Verapress)
Diltiazem (Tildiem, Adizem, Angitil, Dilcardia, , Slozem, Viazem)
Sinus Node Inhibitor
Ivabradine(Procoralan)
What is a Dobutamine
Stress Echocardiogram
(DSE) and why do I need
one?
A Stress Echocardiogram is an
ultrasound test to look at your
heart muscle at rest and during
‘stress’ when it is beating faster
(as if you have been exercising).
We usually ‘stress’ your heart
with a drug called dobutamine
given via a drip in one of the
veins in your arm.
The main reason for doing this
test is to look at the impact
of reduced blood flow to the
main pumping chamber of
the heart when it is being
made to beat faster and pump
harder. This will help us to
determine whether or not, you
have significant narrowing in
the arteries of the heart that
may be responsible for your
symptoms.
The stress echocardiogram can
also be performed to look for
how other heart abnormalities
which may be affecting the
heart function such as problems
with your heart valves.
Do I need to do anything
before the test?
Confirmation:
There is an enormous demand
for these tests and it is
important for you to confirm
your appointment by leaving a
message on:
0161 206 4746
Arriving without confirmation
may cause you to be turned
away as your appointment will
be given to another patient.
It also helps the doctor
responsible for your care to
decide what would be the best
management for your heart
condition.
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© G15121005W. Design Services, Salford Royal NHS Foundation Trust,
All Rights Reserved 2015. Document for issue as handout.
Unique Identifier: CS81(15). Review date: December 2017
2
Are there any alternatives?
If you have been referred
by your doctor or specialist
clinician to have a stress
echocardiogram, the reason for
this test and the alternatives
should have been explained
and talked through with you
before you were referred.
Exercise Treadmill (Stress) Test
You may have already had
an exercise test. A stress
echocardiogram may be
requested by your doctor or
specialist clinician if an exercise
test is unhelpful or impossible.
It is also performed if your
doctor needs more detailed
information than that provided
by a standard exercise test.
Myocardial Perfusion Scan
(Myoview Scan)
This test uses a radio-isotope
agent to assess the circulation
of your heart during rest and
stress. It is used to help to
determine whether you may
have significant heart artery
narrowing(s) and whether your
symptoms are angina.
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What will happen on the
day?
We do not currently perform
stress myoview at Salford Royal
in patients with asthma or other
lung related breathing problems.
Therefore a dobutamine stress
echo is performed in this group
of patients.
Clothing:
Medication:
Whilst this test does not need
you to have any sedation or any
anaesthetic drugs, we would
strongly recommend that you
arrange for someone to drive
you home or to go home in a
taxi and not go home on public
transport or walk home.
Please stop taking the
medications listed on page 1
of this leaflet 2 days (48 hours)
before the test and stop betablockers 3 days (72 hours) prior
to test if you are a dialysis
patient. All these medications
slow the heart beat and do
not allow us to complete the
test. It is important that you
continue to take ALL your other
medications.
If you use a nitrolingual spray /
tablets (GTN) or inhalers you
should bring these with you
to the appointment. You
should also bring a list of all
your medications that you are
taking.
Please wear your normal clothes
but you will be asked to remove
upper clothing. We provide
hospital gowns to all patients.
You should attend the:
Echo Room,
Heart Care Unit
Travel:
Please speak to the secretary
about this if this will be a
problem when you telephone
to confirm the appointment.
Eating and drinking:
You may eat and drink as
normal before coming for your
test.
as this is where the test will
be performed. Please use the
central car park if coming by
car. Patients with restricted
mobility may wish to use
Entrance 6.
Please note there is an
appropriate waiting area and
nearby WRVS cafe for family or
friends accompanying you.
You will be weighed and asked
to lie on the echocardiogram
couch.
Either a doctor or a specialist
nurse will explain the procedure
to you and go through a set of
routine questions.
© G15121005W. Design Services, Salford Royal NHS Foundation Trust,
All Rights Reserved 2015. Document for issue as handout.
Unique Identifier: CS81(15). Review date: December 2017
4
How long does it take?
Your blood pressure will
be checked and monitored
throughout the procedure. If
it is too high we may decide to
postpone the test until it is at
an acceptable level.
Your ECG will also be
continually monitored
throughout the procedure.
Your heart rate will be gradually
increased by a drug through the
drip called Dobutamine.
In this case a letter would be
sent to your GP to let him/her
know to alter your medications.
An additional drug called
Atropine may be given to help
speed the heart rate up further
if required.
You will have a drip inserted
into a vein in your arm (usually
in the fold of your left elbow).
The first part of the test is a
brief check echocardiogram
(ultra sound scan of the heart).
This will allow us to obtain
important information about
your heart pumping chambers
and valves.
The echocardiogram will
be repeated at intervals
throughout the procedure to
check the functioning of the
main pumping chamber.
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The maximum target heart
rate is based on your age and
is generally lower than what
is aimed for during a standard
treadmill test.
A third solution called a
‘contrast agent’ is also given
through the same drip which
helps the doctor to view your
heart chambers more clearly.
When your target heart
rate is reached all the drugs
are stopped and we keep
monitoring your heart rate and
blood pressure until everything
is back to normal.
Overall the whole appointment
time is about 45 minutes.
The ‘preparation time’ is
around 15 minutes. The main
procedure where your heart is
scanned and the drugs to speed
up your heart rate are given
lasts about 12-15 minutes.
The recovery time until
everything is back to normal is
also about 15 minutes.
What happens after the
test?
The senior doctor will explain
the test results to you
immediately after the procedure
and will then write to your GP
and the Doctor or clinician who
referred you for the test.
The effects of the Dobutamine
drug will have worn off by the
time you are ready to go home.
If the drug Atropine was used,
the effects (mainly a dry mouth)
will take longer.
Are there any risks or side
effects?
Most patients report very few
side effects and tolerate the
test very well. The main feeling
is an awareness of your heart
‘racing’ It feels rather strange
because you are not exercising,
but your heart is.
The drugs can make you feel a
tingling sensation on your face
and scalp, a feeling you want
to pass urine, flushing, a dry
mouth and occasionally you
may feel a little sick. These are
normal and these minor side
effects quickly wear off when
the drug is stopped.
If you are having a stress
echocardiogram as part of an
investigation into chest pain,
this may be provoked during
the test. If this happens we may
stop the test and the symptoms
usually resolve very quickly. You
can also use your nitrolingual
(GTN) spray if you wish.
© G15121005W. Design Services, Salford Royal NHS Foundation Trust,
All Rights Reserved 2015. Document for issue as handout.
Unique Identifier: CS81(15). Review date: December 2017
6
For further information:
Serious side effects are very
rare in our practice but may
include a bad attack of angina
or palpitations.
If this occurs we start
appropriate treatment
and occasionally we may
recommend admission to
hospital to monitor your heart,
even if just for a short while.
IF YOU HAVE ANY
QUERIES ABOUT THE
TEST YOU SHOULD
LEAVE YOUR NAME AND
CONTACT NUMBER ON:
0161 206 2031
Notes
http://www.patient.co.uk
http://www.bhf.org.
uk/living_with_a_
heart_condition/tests/
echocardiogram
Endorsements:
Dr Nik Abidin
Consultant Cardiologist
Dr Peter Woolfson
Consultant Cardiologist
Mr Brian Parr
Nurse Clinician (Advanced
Practitioner)
IF YOU CANNOT
TELEPHONE OR IF
YOU WOULD PREFER TO
EMAIL US, CONTACT:
angela.smith@srft.
nhs.uk
WE WILL THEN CALL
OR EMAIL YOU BACK
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© G15121005W. Design Services, Salford Royal NHS Foundation Trust,
All Rights Reserved 2015. Document for issue as handout.
Unique Identifier: CS81(15). Review date: December 2017
8
© G15121005W. Design Services
Salford Royal NHS Foundation Trust
All Rights Reserved 2015
This document MUST NOT be photocopied
Information Leaflet Control Policy:
Unique Identifier: CS81(15)
Review Date: December 2017
For further information on this leaflet, it’s references and sources
used, please contact 0161 206 2031
If you need this interpreting please telephone
Copies of this information are
available in other languages
and formats upon request.
In accordance with the
Equality Act we will make
‘reasonable adjustments’
to enable individuals with
disabilities, to access this
treatment / service.
Email: [email protected]
Salford Royal operates a smoke-free policy.
For advice on stopping smoking contact the Hospital Specialist Stop Smoking Service
on 0161 206 1779
Salford Royal NHS Foundation Trust
Stott Lane, Salford,
Manchester,
M6 8HD
If you would
like to become a
Foundation Trust
Member please visit:
If you have any suggestions
as to how this document
could be improved in the
future then please visit:
Telephone 0161 789 7373
www.srft.nhs.uk/
for-members
http://www.srft.nhs.uk/
for-patients
www.srft.nhs.uk