Stress test

A stress test is also called an exercise stress test and shows how your heart works during physical activity. Because exercise makes your heart pump faster and faster, an exercise stress test can show problems with blood flow to your heart. The stress test measures the effect of physical activity on your heart rate, blood pressure, and respiration, usually walking on a treadmill or stationary bike. In some cases, you will also receive medication that mimics the effects of exercise. A stress test can be helpful if you have signs or symptoms of coronary heart disease or an irregular heart rhythm (arrhythmia). Stress testing may also help with treatment decisions, measure the effectiveness of treatment, or determine its severity if diagnosed with heart disease.

Necessities of stress testing

When will your doctor prescribe a stress test?

 Diagnosis of coronary artery disease

Coronary arteries are your main arteries that supply blood, oxygen, and nutrients to your heart. Coronary artery disease occurs when these vessels become damaged or diseased. This is usually due to the accumulation of deposits containing cholesterol and other substances (plaques).

Diagnosis of heart rhythm problems (arrhythmia)

Heart arrhythmia occurs when the electrical impulses that coordinate your heart rhythm do not work properly, causing your heart to beat too fast, too slow, or too eratic.

Guide to the treatment of heart disorders

If you already have heart disease, exercise stress testing can help your doctor to learn how treatment works. He can also use this method to help you make a treatment plan by showing your heart rate.

Determining the time of heart surgery such as valve replacement

In some people with heart failure, the results of a stress test may help your doctor determine if you need a heart transplant or other advanced treatment. If an exercise stress test does not determine the cause of your symptoms, he or she may order an imaging test, such as a nuclear stress test or an echocardiographic stress test.

Risks of stress testing

Stress testing is generally safe and its side effects are rare. But like any medical procedure, there is a risk of complications in stress testing:

Low blood pressure

Blood pressure may drop during or immediately after exercise and may cause dizziness or fainting. After you stop exercising, the problem should go away.

Abnormal heart rhythms (arrhythmias)

Arrhythmias from an exercise stress test usually go away immediately after stopping exercise.

Heart attack (heart attack)

Although very rare, an exercise stress test can cause a heart attack.

Preparing for a stress test

Regarding the preparation for the stress test, special instructions should be followed with the opinion of the doctor

Food and medicine

You may be asked not to eat or drink for a while before the stress test. You may need to avoid caffeine from the day before the test and the day of the stress test. Ask your doctor if it is safe for you to continue taking all prescribed and over-the-counter medications, as some stress tests may interfere. If you use an inhaler for asthma or other respiratory problems, try it. Make sure your doctor and health care team who monitor your stress test know that you are using an inhaler.

Clothing and personal items

Wear or carry comfortable clothing and hiking boots. If you are experiencing nuclear stress, do not apply oil, lotion or cream to your skin that day.

Steps and how to do a stress test

Your stress test will take about an hour, which includes preparing and performing a real stress test. The actual stress test only takes about 15 minutes. You may have an exercise stress test in which you walk on a treadmill or pedal a stationary bike. If you are unable to exercise, you will be injected intravenously with a drug that mimics the state of your body during exercise by increasing blood flow to your heart.

 Before the stress test

The doctor will first ask about your medical history and the amount and intensity of your physical activity to determine the amount of exercise that is right for you during the stress test. Your doctor will also ask you about any abnormalities that may affect your stress test results. In addition, he or she will listen to your heart and lungs during a physical exam.

During a stress test

A nurse or technician will place electrodes on your chest, legs, and arms. Some areas may be shaved to help the hair stick. The electrodes have wires connected to an electrocardiogram that records electrical signals that stimulate your heartbeat. One hand on your arm measures your blood pressure during a stress test. During a stress test, you may be asked to breathe through a tube to show how much you can breathe during exercise. In the exercise stress test, you exercise with a treadmill or stationary bike and start slowly. As stress tests progress, exercise becomes more difficult. You can use the railing on the treadmill for balance. Do not hang tight, as this may distort the results.

If you are unable to walk on a treadmill or pedal on a bicycle, your doctor will inject you with a medicine that increases blood flow to your heart. You may feel red or short of breath, just like you feel when you are exercising. You may also experience headaches.

You continue to exercise until your heart rate reaches a certain goal or until you develop symptoms that prevent you from continuing to work. These signs and symptoms include the following:

• Moderate to severe chest pain
• Severe shortness of breath
• Abnormal drop or increase in blood pressure
• Abnormal heart rhythm
• Dizziness
• Fatigue
• Make certain changes to your ECG

In general, you can stop the stress test whenever you are not comfortable enough to continue exercising.

After the stress test

After you stop exercising, you may be asked to stand still for a few seconds and then lie down with the monitors for a while. Your doctor can detect any abnormalities as your heart rate and breathing return to normal. When your exercise stress test is over, you can often return to normal activities unless your doctor tells you otherwise. The main test only takes about 15 minutes, while the stress test will take about an hour from preparation to the end of the main stress test.

Stress test results

If the information gathered during the exercise stress test shows that your heart is functioning normally, you probably do not need another test.

However, if the results are normal and your symptoms continue to get worse, your doctor may order a nuclear stress test or other stress test that includes an echocardiogram before and after exercise or medications to increase blood flow to your heart. These tests are more accurate and provide more information about your heart function, but they are more expensive.

If your stress test results indicate that you may have coronary heart disease or an arrhythmia, your doctor will use this information to prepare a treatment plan. In addition, you may need additional tests such as a coronary angiogram.