Exercise Stress Echocardiogram
Patient Information and Consent Form
What is an Exercise Stress Echocardiogram?
A stress echocardiogram combines a heart ultrasound (echocardiogram) with exercise on a treadmill to assess how your heart performs under physical stress. Images are taken at rest and immediately after exercise to look for changes in heart function. No radiation. No needles. No sedation.
Why has my doctor referred me?
- • To investigate chest pain, shortness of breath or reduced exercise tolerance
- • To detect or assess coronary artery disease (blocked heart arteries)
- • To evaluate heart valve problems under exercise conditions
- • To assess fitness for surgery, sport, or work
Important — Before Your Test
- • Do not eat for at least 3 hours before the test
- • Wear comfortable clothing and supportive walking/running shoes
- • Bring a list of all your current medications
- • Unless instructed otherwise by your doctor, take your regular medications as usual
- • Avoid caffeine (coffee, tea, energy drinks) for at least 4 hours before the test
What happens on the day — Step by Step
Arrive & check in
You will be welcomed by our staff and taken to a private room. The procedure, risks and benefits will be explained to you.
Prepare for the test
You will be asked to undress from the waist up. Women will be given a gown worn open at the front. Small sticky electrodes (ECG dots) will be placed on your chest to monitor your heart rhythm throughout.
Resting echo images taken
You will lie on your left side on an examination table. A small amount of gel will be applied to your chest, and ultrasound images of your heart will be captured at rest.
Exercise on the treadmill
You will walk or jog on a treadmill. The speed and incline increase gradually every 3 minutes. You will exercise to a target heart rate set by your doctor, or until you develop symptoms or the test needs to be stopped for safety reasons.
Stress images taken immediately
As soon as you finish exercising, you will quickly lie back on the table. Heart images are captured within 60–90 seconds of stopping exercise to compare with the resting images.
Recovery monitored
Your heart rate, blood pressure and ECG are monitored for at least 5–10 minutes after exercise until they return to baseline. You will remain in the clinic until you feel well.
Test complete — 60 to 90 minutes
The test is finished. You may eat and drink normally. Results will be reviewed by a specialist and sent to your referring doctor.
Risks of Exercise Stress Testing
Exercise stress echocardiography is a safe test performed under medical supervision. Serious complications are rare but can include:
- • Abnormal heart rhythms (arrhythmias) — usually short-lived
- • Chest pain or discomfort
- • A significant drop in blood pressure
- • Very rarely (<1 in 10,000): heart attack or cardiac arrest
Emergency equipment and trained staff are present throughout your test. The test will be stopped immediately if any concerning signs arise.
After the test
- • You can eat, drink and resume normal activities — unless advised otherwise
- • A specialist will review the results and send a report to your doctor within 7 working days
- • Your health information is kept private under Australian privacy law
Privacy Notice
Collection purpose: Your personal and health information is collected by HeartWise Cardiology solely for the purpose of performing and reporting this exercise stress echocardiogram and providing you with specialist cardiology care.
Storage & security: Your information is stored securely in our clinical records system, accessible only to authorised staff and treating clinicians, and retained in accordance with Western Australian health records legislation.
Disclosure: Results and relevant clinical information will be reported to your referring doctor and any other clinician directly involved in your care. Information will not be disclosed for other purposes without your consent, except as required by law.
Sensitive health information: This information is sensitive personal information under the Privacy Act 1988 (Cth) and the Australian Privacy Principles (APPs).
⚠️ Urgent care limitation: This form is for administrative consent purposes only. If you are experiencing chest pain, breathlessness, or any medical emergency, call 000 immediately.
For our full Privacy Policy or to access/correct your information, contact us at info@heartwisecardiology.com.au or (08) 6102 1655.
📋 By signing below, I confirm that I understand and agree to the following:
I understand the nature, purpose, and process of the exercise stress echocardiogram.
I have been informed of the possible risks and rare complications associated with exercise stress testing.
I understand that the test will be stopped immediately if any concerning symptoms or signs arise.
I have had the opportunity to ask questions and am satisfied with the answers provided.
I consent to my personal and health information being collected, stored, and used by HeartWise Cardiology as described in the Privacy Notice above.
I consent to my results being shared with healthcare professionals involved in my care, in accordance with Australian privacy and confidentiality laws.
Sign here with your finger or mouse
By signing above, I confirm the information provided is accurate and I consent to its use for my healthcare.
Perth CBD • Nedlands • Riverton • Joondalup
T: 08 6102 1655 | F: 08 6118 5522 | E: admin@heartwisecardiology.com.au | W: heartwisecardiology.com.au