Exercise Stress Echocardiography (ESE)

Echocardiogram is a procedure wherein sound waves are used to create accurate images of the heart, to identify and diagnose any problems within. These images also depict the blood flow within the heart and through the blood vessels, giving the doctor an accurate understanding of your condition.
In an Exercise Stress Echocardiogram, your heart’s activity and functioning will be looked into using this method, while you are walking on a treadmill. This helps create accurate images of the heart while its in a state of stress, which can be used to further identify and diagnose heart conditions if any.
Exercise stress echocardiograms are often done to identify and determine the presence of the following heart conditions:
  • Coronary artery disease
  • Cardiomyopathy
  • Congenital heart disease
  • Heart failure
  • Pulmonary hypertension
  • Valve disease


  1. What are you actually looking for in stress echo?
    • There are 3 major arteries bringing blood to the heart with each coronary artery suppling a distinct region. When we are calm and restive, our heart pumps slowly and only demands a baseline amount of blood flow and oxygen supply. Even in the presence of coronary artery blockage, usually enough blood get through to keep the heart muscle functioning normally.  However, when we start to exercise and put the heart under pressure, it will have to pump faster and stronger to sustain our physical demand.  In response, healthy arteries expand and allow more blood and oxygen to reach the heart muscle. Unfortunately, arteries with significant blockage will fail to deliver blood supply fast enough to keep up with the increased heart muscle demand. So what we see in the scan is certain region of the heart starts to contract poorly whilst other areas pump more vigorously in response to exercise.  This regional motion abnormalities of the heart is indicative of significant coronary artery disease and warrant further investigations and treatment.
  1. Is it a pain free test?
    • The test does not involve any needle sticks so it is pain free. But make no mistake, to ensure the heart is adequately challenged we do push you to run very hard in order to achieve your maximum heart rate.

  2. I need an all clear from the cardiologist before my knee surgery but I have difficulty walking let alone run, can I still have a stress echo?
    • Yes you can still have a stress test but instead of running on the treadmill to speed up your heart, we can infuse medication to speed up your heart instead. Please discuss this option further with your heart specialist.



Heart Investigations

Our Cardiologist

Dr. Paul Ong

Senior Consultant Cardiologist

BA (Cambridge)
MB BChir (Cambridge)
MA (Cambridge)
CCST Cardiology (UK)
FRCP (London)
FESC (Europe)

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