Contrast Stress Echocardiography (Stress Echo with Contrast)

It is estimated that up to 20% of resting transthoracic echocardiograms (echo) have suboptimal visualization of the left ventricular endocardium, defined as two or more segments not being adequately visualized. A Contrast Stress Echocardiogram addresses this limitation by combining a traditional stress test with an echocardiogram (cardiac ultrasound) and an intravenous contrast agent. The contrast agent significantly enhances image clarity, providing a more detailed assessment of the heart's structure, function, and blood flow patterns under stress. This specialized test is particularly useful for evaluating how well the heart performs during physical exertion and aids in identifying conditions that might not be evident in standard imaging.

Special Instructions

  • Do not wear body lotion or perfume on the day of your test.

  • Wear comfortable exercise clothing, such as a two-piece outfit (e.g., separate top and bottoms). Female patients will be provided with a gown to cover the upper body during the test.

  • Bring running shoes or other suitable exercise footwear and a bottle of water.

  • You may have a light breakfast (e.g., toast and juice) on the morning of the test, but avoid caffeine (e.g., tea, coffee, decaffeinated beverages, chocolate, or soda).

  • Bring a list of all current medications.

  • Do not stop any medications unless specifically instructed by your physician.

During the Test

Electrodes will be attached to your chest and abdomen to monitor your heart's electrical activity. An echocardiogram will be performed at rest and again immediately after exercise. An intravenous (IV) line will be used to deliver the Definity contrast agent, which enhances the clarity of images of the heart's chambers and blood flow.

You will walk on a treadmill while your heart's electrical activity, blood pressure, and heart rate are monitored.

Symptoms and Safety

Mild shortness of breath during exercise is normal, but notify the technologist immediately if you:

  • Experience chest pain or tightness.

  • Feel light-headed, dizzy, or faint.

  • Want to stop the test for any reason.

Note: Medical staff and emergency equipment are available if needed.

Possible Side Effects

The contrast agent is generally well-tolerated, but some patients may experience minor side effects such as:

  • Headache

  • Flushing

  • Nausea

  • Mild discomfort

If you experience any side effects or other symptoms, notify the medical staff immediately.

After the Test

If you have any pre-existing conditions listed on the medical form provided by the office staff, you will be monitored for approximately 30 minutes following the administration of Definity. If no such conditions apply, you may resume your normal activities immediately after the test

Mild redness at the electrode sites is common and typically resolves quickly. 

Duration and Results

The test lasts approximately 45 minutes, but you should allow for about one hour to complete the appointment.

A cardiologist will review the ECG tracings and echocardiographic images, and the results will be sent to your referring physician for follow-up.

Important Information for Your Appointment

Please arrive 10 minutes before your scheduled test to register at the reception desk.

Bring the following items:

  • Your valid OHIP (Ontario Health Insurance Plan) card (to each scheduled appointment). 

  • A requisition form, if provided to you directly by your physician or nurse practitioner.
    (Note: If your physician or nurse practitioner did not fax the referral to our office, you must bring the requisition form signed by your physician to your appointment.)

  • Comfortable exercise clothing and running shoes.

  • A bottle of water (optional).