Echocardiogram with Strain

An echocardiogram with strain gives your healthcare provider a way to diagnose some heart conditions earlier. This newer technique can show less obvious issues with how your heart muscle moves. Providers can use this method to screen people at risk for certain heart issues or monitor those who already have heart conditions.


What is an echocardiogram with strain?

An echocardiogram with strain is an ultrasound test that takes images of your heart and evaluates the function of your heart muscle (myocardium). Using this newer technique that measures heart muscle length during contraction and relaxation, a healthcare provider can identify subtle changes in your heart function. Finding these mechanical abnormalities (issues with how your heart moves) allows providers to make an earlier diagnosis and make a prognosis (determine a possible outcome for the condition).

Echocardiographic deformation imaging is another name for an echocardiogram with strain.

When is an echocardiogram with strain performed?

Providers use this test to:

  • Screen and follow up with people who receive cardio-toxic medications during cancer treatment.
  • Evaluate people who have received radiation to their chest.
  • Evaluate and monitor people who have cardiomyopathy, heart failure (such as before and after receiving a biventricular pacemaker) or pericardial disease.

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Test Details

How does an echocardiogram with strain test work?

A cardiac sonographer will move a handheld device called a transducer over your chest area. The transducer sends high-frequency sound waves (ultrasound) to your heart and transmits them back to the ultrasound machine as live, moving images. This technology gives a provider a comprehensive evaluation of your heart’s function and structure, including the chambers and valves.

How do I prepare for an echocardiogram with strain test?

Here’s how you can prepare for the test:

  • You may eat and drink as you normally would on the day of the test.
  • Take all of your prescribed medications at the usual times.
  • You may wear anything you like, but you’ll change into a hospital gown (from the waist up) before the test.
  • Don’t bring valuables with you.
  • Put your belongings in a locker.
  • Listen to a provider explain the procedure in detail, including possible complications and side effects.
  • Ask questions if you have them.

What can I expect during the echocardiogram with strain test?

The test takes about one hour. It usually takes place in an echocardiogram lab. During an echocardiogram with strain, a cardiac sonographer will:

  • Place three electrodes (small, flat, sticky patches) on your chest. The electrodes send information to an electrocardiograph (EKG) monitor that charts your heart’s electrical activity during the test.
  • Ask you to lie on your left side on an exam table, sometimes with your left arm above your head.
  • Place a device called a transducer on several areas of your chest. The end of the device will have a small amount of gel on it, but it won’t harm your skin. This gel helps produce clearer pictures.
  • Ask you to change positions several times during the exam so the sonographer can take pictures of different areas of your heart.
  • Ask you to hold your breath at times.

How will I feel during the test?

An echocardiogram isn’t invasive, so you shouldn’t feel any major discomfort during the test. You may:

  • Feel coolness on your skin from the gel on the transducer.
  • Feel the transducer pressing on your chest.
  • Hear the sounds from the equipment during the test.

What should I expect after the echocardiogram with strain test?

After the test, you may get dressed and go home or go to your other scheduled appointments. You shouldn’t have any side effects from the test, unless you received medicine to make you sleep during the test.

Results and Follow-Up

What type of results do you get and what do the results mean?

After a cardiologist reviews your test, they’ll enter the results into your electronic medical record. Your provider will have access to the results and will discuss them with you. They’ll tell you what the images show and whether you need treatment for a heart issue.

A note from Cleveland Clinic

Hearing that you need a test on your heart can make you feel uneasy, but an echocardiogram with strain isn’t invasive. Your healthcare provider can get the information they need from an ultrasound device they move across your skin. Feeling the device pressing against your skin is the most discomfort you’ll feel.

Medically Reviewed

Last reviewed by a Cleveland Clinic medical professional on 10/31/2022.

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