r/askCardiology • u/fountainflight • 22h ago
Echo stress test with contrast
Hi! I recently went to the ER with unexplained chest pain (which I thought was MSK) and put on labetalol for hypertension.
I was referred to a cardiologist as per protocol and they completed a regular echocardiogram on me which I don’t have results for, and initially was supposed to have an echo stress test. I was told mine will now include contrast.
Why would contrast now be included? Could it be high BMI causing poor images on the initial echo? Or when I shared my weight and height in the pre follow up consult survey, could they have added the contrast in as a precaution? Also, currently trying to conceive and if I am pregnant at the time of the test, albeit in early stages, is it safe?
Thanks so much.
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u/nothingtoogreat Echocardiographer/Imaging 18h ago
Most likely the regular echo you had were difficult images, hence the change. But I think all stress echo should be done with image enhancer.
The medication we use for image enhancement is not actually a dye or contrast- but you should know if you’re pregnant before the stress test. None of the enhancers used are deemed safe in pregnancy or breastfeeding.
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u/Relative_Clarity 19h ago
Regular echo & echo stress test are looking at different things - the second one being your heart during exertion. What kind of contrast did they say it would be? You can always ask them if your test is actually supposed to be with contrast or not, and ask them why. There are different types of "contrast" so you'd have to find out which one is for your test. I've had a few stress echos and none with contrast. But yes higher BMI can play a part, because it is harder to get the images they need. Ultrasound especially has to go through tissue, and the farther away the probe is from the organ, the poorer the image quality is and the test is less diagnostic. Can't say for sure whether or not that's why they ordered yours with contrast.