A dobutamine stress test mimics the heart’s response to exercise by injecting the drug dobutamine to increase the heart rate. Cardiolite is also administered to create clear pictures of the coronary arteries. The test can take one to three hours and can be used to find out about coronary problems in individuals who are unable to take a treadmill stress test. Side effects such as headache, dizziness, and shortness of breath can occur during the test, and patients are usually monitored until their heart rate and blood pressure have returned to normal.
A dobutamine exercise test works by mimicking the heart’s response to exercise without the need for physical effort. This test is done by giving a drug called dobutamine to increase the heart rate. Another compound called Cardiolite® is also often administered during the test to help create clear pictures of the coronary arteries. During the test, two series of images are taken: one to show the heart’s response during the resting phase and a second to show the heart’s response during the stress phase. A dobutamine stress test can be used as a simple and accurate way to find out about coronary problems in individuals who are unable to take a treadmill stress test.
Knowing what to expect before a dobutamine stress test can be helpful in preparing for the experience. Depending on whether the dobutamine stress test is done with an electrocardiogram (ECG) or nuclear imaging, the test can take one to three or more hours to complete. Your doctor will most likely give you a list of guidelines to follow on the day of the test. These may include instructions to fast before the test and to avoid caffeine and cigarettes, both of which can cause problems with the test.
The dobutamine stress test does not require physical effort, so most of the testing takes place while sitting or lying down. If a dobutamine stress electrocardiogram is to be done, an ECG monitor is used to monitor the patient’s heart rate, starting with a reading at rest. Blood pressure readings are taken and an echocardiogram is often done to get a look at the patient’s heart before the stress test itself.
In a dobutamine nuclear stress test, Cardiolite®, also known as sestamibi, is injected and images are captured with a gamma camera. Cardiolite® contains trace amounts of radioactive material to make coronary arteries visible in images. Each time it is administered, it needs at least 30 minutes to circulate through the body.
After rest pictures are taken, dobutamine is injected into the vein via an intravenous (IV) line. This takes 12 to 15 minutes and more Cardiolite® can be injected soon after. Dobutamine increases the patient’s heart rate, providing an exercise-like response. In both nuclear and electrocardiographic tests, an ECG is used to monitor the patient while dobutamine is being administered.
In addition to the increased heart rate, other side effects such as headache, dizziness, and shortness of breath can occur during a dobutamine exercise test. While these reactions are usually normal, they should be reported to laboratory personnel, as they could indicate a serious problem. The patient should be monitored throughout the process and the drug may be discontinued if any unexpected side effects occur.
Each set of images – at rest and stressed – takes around 15 minutes to run. When the images are taken, the patient is usually asked to lie still with the left arm raised above the head. This allows the camera or ultrasound transducer, depending on the test, to capture the necessary images. After the test is complete, patients are usually monitored until their heart rate and blood pressure have returned to normal.
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