Hi Al -
There are different ways that they do them; I know of three ways. I personally find them so incredibly uncomfortable, and worse, that I refuse them now. Not everyone feels that way. But, remember, there is a reason why they are called STRESS echos. They will attach all of the normal EKG sticky things to you before they begin.
Pre-AVR, I was given them with a treadmill. You walk and they increase the incline and they push you until you really have no more to push. Just about the time you think you are just going to die, they rush you over to a table and run the echo over you to catch this or that.
There are also stress echos that are done where the patient is on an exercise bike and they increase the tension and then rush you over to the table, etc.
Post-AVR, I was given a different one, which I previously tried to describe on this site but I don't think anyone else here has seen what I was describing and they thought I was describing riding on a bike. The LA cardiologists I go to told me that the stress machine I used had been designed specifically for them. I can see the advantages to this new design. I was on my back, and had my feet up in the air, pedaling a bike-like wheel which was attached to the end of the table. They kept increasing the tension, while having me rotate the wheel, so many rotations a minute, I think it was 70. While I was at the point of total exhaustion and my torso and heart and lungs felt like they were on fire, they simultaneously ran the echo machine on me. That was a little less than one year post-op for me and I really felt like that experience set my recovery back somewhat. So I refuse them for now and just take regular echos, which aren't able to see as much.
The advantage of that most recent one that I was given is that they lose no possible measurement from the time a person leaves the stress machine, whether it's a treadmill or an exercise bike, to the few moments where they lay down on the table to begin the echo. They ran the echo on me while I was at the point of exhaustion, STRESSED.
My dad had severe hypertrophic cardiomyopathy and he literally died, for lack of a better word, on a treadmill during a stress test; flat-lined. They had to use the heart paddles on him three times, increasing the voltage or whatever three times, and were happily finally able to get his heart beating again. The paddles burned his chest. That must be a worst-case scenario, but you will notice that they have those chest paddles nearby in the stress echo room.
Perhaps my dad and I had worse experiences with stress echos than others. And I don't mean to frighten you. This is just my personal experience with stress echos.
I hope everything goes well for you. Have you never had one before?
