What's the Difference Between a Stress Test and an Echocardiogram?

A strong, healthy heart is essential for a long and healthy life. But more than 30 million Americans are living with heart disease, a term used for a group of conditions that compromise heart health. 

Heart disease and other heart problems are common, but it doesn’t mean you have to watch your health decline. Diagnosing heart problems and monitoring them with advanced testing is the first step to improving your well-being when you’re living with a heart condition. 

NJ Cardiovascular Institute provides comprehensive diagnostic testing to our patients. Under the leadership of Kunal Patel, MD, our team regularly evaluates heart health with stress tests, echocardiograms, and other assessments. While all heart tests aim to identify and evaluate potential problems, each one serves a unique purpose. 

We share more about stress tests and echocardiograms — two of the most common heart tests.

Stress test

A stress test is a noninvasive test that assesses how your heart operates under physical stress. It’s sometimes called an exercise stress test because it involves exercising to elevate your heart rate. 

Stress tests can be helpful in diagnosing heart conditions such as coronary artery disease and arrhythmias, which are irregular heartbeats. Stress testing may also be an element of ongoing monitoring if you’ve already been diagnosed with a heart condition.

Participating in a stress test is a simple in-office procedure. Our team gives you instructions to prepare for your stress test. Depending on your situation, you may need to avoid caffeine, nicotine, and certain medications for a period of time before your stress test. Sometimes, fasting is recommended. We give you complete instructions so you’re prepared.

At the beginning of your stress test, your doctor listens to your heart and lungs. He attaches electrodes to your chest and legs, and places a blood pressure cuff on your arm, so we can monitor your blood pressure and heart rhythm throughout the test.

You then begin walking on a treadmill or riding a stationary bicycle. The team monitors your heart rate and assesses how well your heart performs under the stress of physical activity. If you experience chest pain, shortness of breath, or other symptoms at any point during your test, you need to let us know.

There’s no downtime required after your stress test is complete. Our team reviews the results of the test and uses the information to guide our treatment recommendations for you.


An echocardiogram is an ultrasound procedure to evaluate your heart health. Ultrasounds are noninvasive tests that use harmless sound waves to create images of your heart.

Our team orders echocardiograms for a number of reasons, including:

If you have an existing heart condition, echocardiograms may be part of your routine healthcare. They can be used to assess how well a specific treatment is working and monitor your heart health over time.

There’s no special preparation required for an echocardiogram. When you come in for your test, the team may give you a gown to wear. You lie on your left side on a special exam table, your technician applies ultrasound gel to your chest.

The technician moves an ultrasound wand called a transducer over your chest, capturing images of your heart in action. You’ll remain lying down for the duration of the test, which takes about 40 minutes from start to finish. Ultrasounds aren’t painful, and you can return to your normal daily activities after you leave the office.

Sometimes the two tests are done together

When we want to see images of your heart pumping after you’ve exercised, we do a stress echocardiogram, usually called a “stress echo” for short. 

First, we do a regular echocardiogram to see images of your heart when you’re at rest. Next, you go through the regular stress test by walking on the treadmill or riding the bike. Then you quickly return to the exam table so we can do another echocardiogram to see images of your heart when it’s beating faster after exertion.

At NJ Cardiovascular Institute, our team is equipped to diagnose and treat issues affecting heart health. Our cardiology services are available at two offices in Newark and Secaucus, New Jersey. Find out if you could benefit from heart testing by scheduling a consultation online or calling the office nearest you

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