This is a non-invasive test which uses soundwaves and ultrasound gel to obtain images of the heart.  Multiple different views of the heart are obtained to ensure that all structures are visualized.  Color flow and Spectral doppler allow the Sonographer and Physician to see and hear the simulation of the blood flow through the heart and across the valves.  With this technology the physician is able to measure the size of the heart structures, thickness of the muscle and visualize the function of the muscle and the valves.

There is no prep for this exam and it takes approximately 30 - 45 minutes.  3 electrodes are placed on the chest to obtain the heart beat. Then the Sonographer will place a small transducer on the chest in multiple places to obtain the images and measurements needed for a diagnosis.  

Indications include the following: heart palpitations, heart murmur, racing heart, chest heaviness or tightness, family history of heart disease, syncope, valvular heart disease,  congestive heart failure, stroke, heart attack, chemotherapy, pericardial effusion, and evaluation for heart device implant ect...

Middletown Cardiovascular Sonographers are board certified by the American Registry of Diagnostic Medical Sonography. Each Sonographer has more than 12 years of experience.  Middletown Cardiovascular labs are accreditited by the Intersocietal Commission for the accreditation of Echocardiography Laboratories (ICAEL) and our equipment is state-of-the-art.

Stress Echo

A Stress Echo combines echo images of the heart before and after exercise.  It allows the physician to evaluate the function of the heart before and after stress.  When a heart muscle is getting a good supply of blood through it's coronary arteries the heart becomes more vigorous with the activity.  However,  an indication of a blocked or narrowed coronary artery can be detected by a decrease in the wall segments fed by that artery.  The doctor evaluates all segments of the heart to evaluate if a patient has Coronary Artery Disease.  It is important to understand that this non-invasive test does not actually image the arteries themselves.

For patients who are unable to exercise on a treadmill, there are medications that can be used (such as Dobutamine) to simulate exercise by increasing the heart rate for a few minutes.  When the medication is stopped, the heart slows back down to a normal rate, similar to stopping exercise.

The test takes approximately one (1) hour and includes everything from start to finish. (preparation, resting ultrasound images, walking on the treadmill, and post exercise images)

How to prepare for the test:

Do not eat or drink three (3) hours prior to the test.  This will help prevent the possibility of nausea with exercise.

If you are currently taking medications, be sure to check your instructions to see if your doctor wants you to take them or not, on the day of the test.  If you are still not sure, contact our office, a nurse will be happy to assist you.

What to wear?  Comfortable, loose fitting clothing and good sturdy gym shoes.  No sandles, flip flops, clogs or high heals, if your doctor ordered an Exercise Stress Echo. (Shoes do not matter with a Medicated Stress Echo).

 MCA's Echo Lab is an accredited Lab through the Intersocietal Commission for the Accreditation of Adult Echocardiography and Stress Echocardiography (ICAEL) since December 2008.  Reaccreditation occurs every three years upon the submission of case studies, meeting minutes, reports meeting strick criteria and a review of our protocols and continuing education of our registered Technologists.  For more information about the ICAEL you can visit their website: