Is a Dobutamine Stress Echo the same as a Transiesophageal Echocardiogram?

[Imin]

After months of chasing a diagnosis for ongoing chest pain after having a HA and two stents fitted (I had none before the HA and stents) I received a letter telling me I had been placed on a waiting list to have a Dobutamine Stress Echo. A few weeks later I got an appointment with an information leaflet for a Transiesophageal Echogardiogram. Does anyone know if these are the same procedure with different names please? Has anyone had this procedure? Can anyone give me an idea as to what to expect?

Many thanks in advance for any replies x

[84green]

Hi Imin

I may be wrong but my understanding is that a transiesophageal echocardiogram (TEE) is an echocardiogram where an ultrasound monitor is inserted via the oesophagus. It is similar to a traditional echocardiogram but considered more accurate because the monitor is closer to your heart.

The Dobutamine Stress Echo (DSE) is a rest of how your heart reacts to stress (ie exercise). I had one of these recently. It’s quite straight forward. In my case, you walk on a treadmill (or use an exercise bike) until you reach your maximum heart rate.

You may be injected with dobutamine if you can’t exercise of to help you achieve maximum heart rate. It basically stimulates your heart.

You have an echocardiogram before you start and as soon as you finish. Throughout you have an ECG which throws out print outs and and wear a blood pressure monitor.

I think the idea is that if you can reach a certain time without it causing changes on the echocardiogram, then your heart attack risk over the next few years is regarded as very low.

I was told beforehand that if I was running regularly for 30 minutes without symptoms I should be fine with the test and that was apparently the case the cardiologist said my results were “as normal as they could be.” So, I’m sure you’ll find the DSE a source of reassurance.

I’m sure someone can give you more detail but they are two separate tests for sure.

It may be as simple as the hospital has included the wrong leaflet and you can resolve matters with a phone call.

Best wishes

[Imin in reply to 84green]

Thanks so much for that. I agree, a quick phone call may be in order to find out which one I’m having.

Hope you are keeping well. I’m glad to read that your recent test was normal as could be for you.

Take care x

[84green in reply to Imin]

Good luck Imin

It seems an admin error is quite possible if you were expecting a DSE appt. I would also think a traditional echocardiogram would precede a TEE.

With your current fitness level, I’m sure you’ll be fine. The DSE is regarded as an effective and accurate diagnostic tool.

I was lucky in that the cardiologist was present in the room when I had mine so I got instant feedback and to ask questions.

I have been having all sorts of rib, shoulder and back pains that doctors didn’t believe were cardiac related so it was a reassuring test in that respect. Not sure if the pains are muscular or statin side effects. Physio thinks they might be related to weight loss and increased exercise.

Interestingly, the cardiologist recommended I take 40mg of Atorvastatin instead of current 20 as he believed I should aggressively treat the atherosclerosis (I have two mild blockages, haven’t had a heart attack). My cholesterol is 3.1 (LDL 1.5, Triglycerides 0.9).

Having spoken to my GP, I’m currently on a two week statin holiday. Pains seem to have reduced but that could be in my mind I suppose! I may resume onto Rosuvastatin to see if that makes a difference.

Let me know how it goes for you.

[Imin in reply to 84green]

My GP’s first response when I spoke about ongoing pains was “it’s probably the ticagrelor or the atorvastatin but I’m not stopping or tweaking either until you’ve been on both for 12 months”!

I wrote a letter to the cardiologist asking for any tests that could reassure me that all is as they expect with heart and circulatory system as phrases such as “likely not to be cardiac” and “probably more likely to be...” don’t quite settle my anxieties enough. I like to work with something more definitive. I know they can’t say definitively that I won’t have another HA in the next few years but I can work with facts and figures and evidence.

I didn’t get a response from the cardiologist so made a private appointment for an echo and regular stress test on the treadmill which is happening tomorrow. Wouldn’t you know, the day after I secured the private appointment I get a letter telling me I’m on a waiting list for DES. I kept private app as didn’t know how long the waiting list would be then yesterday I got a letter with the appointment for a TEE which will be in two weeks time!! I will make a phone call to ask which test the appointment has been made for and then, while I am discussing tomorrow’s test results with the private cardiologist if he thinks it is necessary to go ahead with a further, more invasive test. Fingers crossed I get enough reassurance from regular stress test and echo and he won’t deem it necessary to keep the DES or TEE. I can then cancel and free up the nhs app for someone else. All a bit complicated but hopefully tomorrow’s tests and their results are clear enough to give me enough confidence that the pains are indeed not cardiac related.

Equally, I am hoping that GP may be right and in six weeks time I will stop my ticagrelor If pains are still persisting she might consider tweaking the other meds, starting with the statin to see if I can get some pain free days ahead!

As always, nice chatting with you x

[Smileyian in reply to Imin]

Do advise us all of the outcome.