All the standards for transthoracic echocardiography in addition to the following:

Staffing and training.

1. All centres should have a designated Head of Stress Echocardiography, normally the Clinical Head of Department
2. Stress echocardiography studies require an experienced operator and a sonographer or trained nurse
3. The study reporter must be specially trained in stress echocardiography
4. There must be a mechanism in place for feedback to assess clinical correlation
5. Each operator/reporter should perform or directly supervise at least 100 studies per annum
6. Continuing education must be provided for the interpreter
7. At least one member of staff performing the study should possess at least Immediate Life Support (ILS) Training or be a specialist cardiologist
8. A list of indications for stress echocardiograms should be agreed
9. Appropriate protocols for studies should be established and the Head of Stress Echocardiography must be responsible for ensuring that all operators adhere to them

Organisation and equipment

Ideally there should be appropriate provision of

• Designated room (size >25 m²)
• Stress echocardiography software
• Contrast agents and contrast specific software
• Infusion syringe for pharmacological stress or equipment for exercise stress e.g. bicycle
• ECG monitor and recorder
• Sphygmomanometer
• Resuscitation apparatus and drugs readily available