Exercise stress echocardiogram (stress echo) is a useful test to assess coronary artery disease, exercise related arrhythmias (abnormal heart rhythms) and some causes of shortness of breath. 

The common clinical scenarios which require investigation with a stress echo include the following:
• Shortness of breath 
• Chest pain 
• Strong risk factors for heart disease (eg. Diabetes)
• Other symptoms related to exertion
 
A stress echo involves the patient performing exercise on a treadmill using set protocols. The patient is monitored by ECG (heart trace) during the test, and echocardiogram images are obtained before and after exercise. Blood pressure, heart rate and exercise capacity are recorded during the test.

The suitable patient for a stress echo needs to be able to talk on a treadmill up a gentle incline for several minutes. It is advisable that the patient wears comfortable clothing and shoes suitable for exercise. Medications which decrease heart rate (eg. Metoprolol) should be withheld 12 hours prior to the test. This should be discussed with the cardiologist.