Stress Test (treadmill test) versus Two-Dimensional Echocardiogram: Which is better

 What are a stress ECG test and a  Two-Dimensional Echocardiogram (2d echo test)?

During a stress ECG test (treadmill test), you will exercise on a treadmill or stationary bike while your doctor monitors your blood pressure and heart rate.   The ECG tracings indirectly reveal how well your coronary arteries dilate (widen) in response to an exercise. The more they widen, the healthier they are and less likely they are to cause a heart attack or other serious problems later on. Healthier arteries mean no ischemic changes in the ECG graph during a treadmill test. Narrowed arteries produce ischemic changes in the ECG graph during a stress ECG test (treadmill test). So, the stress EKG test is an indirect test to detect coronary artery disease whereas coronary angiography is a direct test that visualizes them directly.

Echocardiography (2d echo test)  is a non-invasive procedure that uses sound waves to create images of the heart. It takes the picture of your heart from different angles. It is done with a cardiac probe on an ultrasound machine.

In this article, we are discussing 2dthe  echo vs the TMT test and you can choose which test to undergo for your heart check-up.

What are the Applications of a Stress ECG Test (treadmill test) and a Two-Dimensional Echocardiogram (2d echo test)?

Stress ECG testing (treadmill test) may be ordered if coronary artery disease is suspected or if abnormalities are found on the ECG or baseline echocardiogram (2d echo test) that require further investigation. When a patient has a normal ECG and echocardiogram (2d echo test),  if a doctor determines that additional tests are needed to make a diagnosis of CAD (coronary artery disease), they may recommend an exercise stress EKG test. A heart stress test (treadmill test) can also be used to evaluate a patient’s prognosis after a myocardial infarction (heart attack). A stress ECG test (treadmill test) is usually ordered by a doctor to evaluate blockage of the heart (known as coronary artery disease), but it can also be used to evaluate the general performance of the heart under stress. Patients with an abnormal exercise test usually require additional tests, such as coronary angiography (cardiac catheterization).

Echocardiography can visualize heart valves, heart muscles, pericardium, aorta, pulmonary artery, and pulmonary veins but it can not study the anatomy of coronary arteries and associated blockages. 2d echo test (Two-Dimensional Echocardiogram test) can not assess how well the blood is flowing in the coronary arteries. For that, we need a stress ECG test (stress ECG test or stress echocardiogram test, or nuclear stress test ) and/or coronary angiogram.

 

What can not be assessed by a Stress ECG Test (treadmill test) and a Two-Dimensional Echocardiogram (2d echo test)?

The stress ECG test (treadmill test) is not a scanning test for the heart, unlike an echocardiogram (2d echo test). It can not visualize the anatomy of the heart. The stress ECG test (treadmill test)is another ECG test that is being done while you are exercising on a treadmill. It studies the electrical activity of the heart. The stress ECG test (treadmill test) can not be used to study the following

• Dimensions of the heart
• Chamber enlargement in the heart
• ejection fraction of the heart
• Valves of the heart like the mitral valve, aortic valve, tricuspid valve, and pulmonary valve
• The thickness of the heart wall
• Pericardium
• Aorta
• Pulmonary artery
• Tumor or clot inside the heart

A two-Dimensional Echocardiogram (2d echo test) can assess all of the above but is not helpful to identify blockages in the heart (coronary artery disease).

Therefore, there is no clear winner as far as applications of the tests are concerned regarding TMTthe test vs the 2d echo test.

How to Perform a Stress Test (treadmill test) and a Two-Dimensional Echocardiogram (2d echo test)

You will be asked to shave your chest hair if yohae any before the test, A gel is applied to your chest. Adhesive electrode patches will be attached to your chest area where the gel is applied. You will be asked to run on a treadmill machine. After every 3 minutes, speed and tilt of the treadmill increase. You need to run faster and harder as stages progress. ECG, blood pressure, heart rate, and oxygen saturations are measured at every stage  Once the test is completed,  ECG, blood pressure, and heart rate oxygen saturations are again taken during the recovery period.

For a Two-Dimensional Echocardiogram. You will be asked to lie on a hospital table or a bed. Your doctor will apply a gel to your chest. The cardiologist will keep the probe on your chest area and takes the images of the heart from different angles. He moves the probe to and fro, left and right to get better quality images.

What are the risks of a TMT test (stress ECG test) and a Two-Dimensional Echocardiogram?

TMT test is a very common and essential cardiac test. There’s very little risk to having a stress test.  There are occasional chances of heart attack, arrhythmia, and sudden deaths during the TMT test (stress ECG test).

A two-dimensional two-Dimensional Echocardiogram is absolutely a safe test and carries zero percent risk.

If we compare the TMT test vs 2d echo, 2d echo wins the battle as far as complications are concerned.

What are the contraindications of a TMT test (stress ECG test)  and a Two-Dimensional Echocardiogram (2d echo test)?

TMT test (stress ECG test), as it has some risks, some patients should not perform it. If you have the following conditions, you can not have a TMT test (stress ECG test).

• Heart failure
• Ongoing heart pain or angina
• Heart attack or myocardial infarction of fewer than 48 hours duration
• Aortic valve stenosis
• Mitral valve stenosis
• Pericarditis
• Myocarditis
• Pericardial effusion

For a Two-Dimensional Echocardiogram, there are no contraindications as it is risk-free. Moreover, if you have a problem in your back or legs that makes you unfit for exercising on a treadmill, you can not do a TMT test. There are no such limitations with the 2d echo test.

When comparison comes 2d echo vs TMT test regarding contraindications, the 2d echo test is the clear winner.

Which is better- a stress ECG test (TMT test) or a 2d echo test?

Two-Dimensional Echocardiogram and stress ECG tests are not alternatives to each other. They are supplementary to each other. The information your doctor gets from the 2d echo test can not get from a stress ECG test. Similarly, the information your doctor gets from a stress ECG test can not get from a 2d echo test (Two-Dimensional Echocardiogram test). When it comes to the 2d echo vs TMT test, there is no clear winner. Both are better in their own way.

The stress test is used to evaluate a patient for coronary artery diseases. It can indirectly identify blockages in your heart,., It is sometimes used for assessing prognosis in certain diseases like hypertrophic cardiomyopathy. It is helpful even in arrhythmia that occurs during exercise

Two-Dimensional Echocardiogram is a pain-free, non-invasive, risk-free test to study the function of the heart (ejection fraction), the function of the valves (mitral valve, aortic valve, pulmonary valve, tricuspid valve), tumor or mass in the heart, the thickness of the heart muscle and so on. It can not identify blockages in coronary arteries. But, if we combine exercise with a 2d echo test, blockages can be identified. This is called a stress echocardiogram.

Your heart specialist is an expert in choosing the right test for you among the 2d echo and TMT tests.

A final word about stress echocardiogram

An exercise echo is a test that combines both an ultrasound of the heart (echocardiogram) and an exercise test. In an echo stress test, your heart is visualized using echocardiography while you are resting and immediately after exercise. Stress echocardiography, also called stress echocardiography or stress echocardiography, is a procedure that determines the functioning of the heart and blood vessels. Stress echo testing may be ordered if coronary artery disease is suspected or if abnormalities are found on the ECG or baseline echocardiogram that require further investigation.

A stress echocardiogram is expensive compared to a stress ECG test. My first choice is always a stress ECG test for coronary artery disease says dr. Malleswara Rao, a cardiologist in Hyderabad

Find your nearest stress test or 2d echo test (Two-Dimensional Echocardiogram test) near you with Dr. Malleswara Rao. We offer a complete range of diagnostic and therapeutic services for heart diseases, cardiomyopathy, and other cardiac conditions. We are experts in deciding the right test for your heart among 2d echo and the TMT test.