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What is an exercise stress echo and how is a stress echo done?

An exercise echo, also known as a stress echo, combines a normal echo (heart scan), with an exercise test with bicycle. What can such a cardiac test reveal? Well, the test helps doctors to find the cause of symptoms (usually chest pain or breathlessness) during physical stress or exercise. Usually you should stop your B-Blocker  or other medicines lowering your Heart Rate (pulse) 2 days before the test. Please ask your Doctor or Dr Kosta before your appointment.


There are two parts to the test:


  1. We will ask you to remove your clothes from the waist up, to wear a gown and to lie on an echo bed. Do not use any kind of creams or lotions on your chest for at least 24 hours prior to the test. Many women typically ask, "Can I wear a bra throughout a stress test?" During the test process, you will not wear a bra of any type. For female patients we provide a gown. Three little sticky patches, called electrodes, will be attached to your chest and connected to the echo machine. Ten more small sticky patches will be attached to your body and connected to the ECG machine.The doctor can then perform a standard resting echo.

  2. We will then ask you to do a bicycle exercise so we can perform a second echo to complete the test.


Bicycle exercise

This test is done on a custom made exercise bed that looks like an echo bed, but has bicycle pedals where your feet will be. You will remain lying on the echo bed during the whole test. 


Your blood pressure will also be recorded before and at regular times during the test. 


The bottom part of the bed is removed and the bicycle pedals are set up to best fit your legs. We will ask you to pedal while lying down. The bicycle exercise is set so that it gets harder to pedal every two minutes.


Once you have reached your target heart rate (based upon your age), we will perform the second echo. The cardiologist may also ask you to stop if you develop certain symptoms such as chest discomfort, shortness of breath, weakness, dizziness, leg discomfort or significant changes in your blood pressure or ECG.


It is very important to try your best during the test, but please do not push yourself to limits that make you feel unwell. At the end of the test, your doctor will ask you to keep pedalling at a slow pace so your muscles can warm down. 


You will relax on the bed for about 5-6 minutes or until your blood pressure and heart rate return to resting levels. Once you are rested and feel well, the doctor will end the test and disconnect you from the equipment.


How safe is an exercise echo?

The risk of complications associated with an exercise echo are extremely low.

It is the same as any type of stress exercise, like climbing stairs or carrying heavy shopping.

Medical staff and/or Dr Kosta are always present to manage any complications that may occur, such as palpitations, unrelieved chest pain, or even a heart attack. 


How do I prepare for a stress echocardiogram?

It is a good idea to wear comfy clothing and shoes or trainers which we will not take off your feet.

Some patients bring a cold drink with them to have after the test. Drinking water is available.

Can you eat and drink before a stress echo?

We suggest that you do not eat a heavy meal in the two hours before your test.

You may be requested to stop specific heart medicines one or 2 days before the check.

We will advise you after you book the appointment for your check.

If you are unsure, please ask.


The results

The echocardiography stress test is very reliable. The doctor (heart specialist) will analyse your exercise echo, ECG and blood pressure results and produce a report for your own doctor. 

If you have any mobility problems, severe lung disease or severe valve problem this test may not be suitable for you. Please ask Dr Kosta. For Health & Safety reasons the test takes part at Ealing Hospital (Under Trust Plus).

Useful contacts

If you are booked to come in for a stress echo and have any questions or would like further information please contact us on 02085742384 or at


  • 2 Harley street, London, W1G 9PA

  • Ealing Hospital, Uxbridge Rd, Middlesex, UB1 3HW

  • Richmond, Parkshot House, 5 Kew Road, Surrey TW9 2PR (opposite Richmond Tube Station)

0208 574 2384 

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All patients are entitled to have a chaperone present for any cardiac consultation, examination or procedure, where they feel one is required. Patients have the right to decline the offer of a chaperone. However the clinician may feel that it would be wise to have a chaperone present for their mutual protection.

If you feel that the situation is life threatening dial 999.

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