The normal echocardiogram is performed with the patient at rest even though symptoms related to heart valve disease occur on exertion.  In some people a stress echocardiogram which mimics exertion is needed for a complete examination.  This can be requested for a number of reasons:

Reasons to perform a stress echocardiogram in heart valve disease:

  1. To detect hidden symptoms 
  2. If you have breathlessness but the valve disease does not appear sufficient to cause this.  Sometimes this is because the valve disease becomes worse on exercise. At other times there may be blockages in the arteries of the heart. A stress echocardiogram will show the heart pumping less well on exercise than at rest.  
  3. Sometimes your cardiologist might want to check that the left ventricle and valve disease are not deteriorating even in the absence of symptoms.  This is not done routinely but is a reasonable thing to do especially with severe mitral or aortic regurgitation.  It is sometimes done as a safety check before planning pregnancy or undergoing a major non-cardiac operation.  

During the stress echocardiogram, live pictures of your heart will be taken either during exercise (if the procedure is carried out using a reclining bicycle) or shortly afterwards (if the exercise is performed using a treadmill). The procedure lasts around 30-45minutes, although typically you will only be exercising for around 5 to 10 minutes. Your blood pressure will be checked regularly during the exercise and your heart rate will be monitored continuously via wires placed on the chest.