A stress test is a common diagnostic procedure ordered by a cardiology,
primary care, internal medicine, or emergency room provider to evaluate
how well the heart works during exercise, or how well the blood flows
to the heart when a medication is given that makes the heart respond as
if you were exercising.
Types of Stress Tests:
Exercise Treadmill Stress Test: This involves walking on a treadmill with increasing speed and incline
every 3 minutes while healthcare professionals observe your heart rhythm
on a 12-lead EKG, blood pressure, oxygen levels, symptoms, and your exercise
capacity during the test.
Exercise Stress Echocardiogram: This is the same process as an exercise treadmill stress test but adds
an echocardiogram (ultrasound of the heart) before exercise and at peak exercise.
Nuclear Treadmill Stress Test: This is the same process as an exercise treadmill stress test but you
are given a small, safe amount of radioactive material (tracer) that is
injected into your bloodstream through an IV, and a special camera takes
pictures of your heart before and after exercise as the tracer travels
through the arteries in your heart.
Lexiscan Nuclear Stress Test: You are given a vasodilator (Lexiscan) through your IV that makes the
heart respond as if you were exercising during the “stress”
portion of the test, and you are given a small, safe amount of radioactive
material (tracer) that is injected into your bloodstream through an IV
and a special camera takes pictures of your heart before and after exercise
as the tracer travels through the arteries in your heart.
What does a stress test detect?
Diagnose coronary artery disease. The coronary arteries are the major blood
vessels that bring blood and oxygen to the heart. Coronary artery disease
happens when these arteries get damaged or diseased. Typical symptoms
of coronary artery disease are chest pain and shortness of breath with
exertion. A stress test can detect a significant blockage in a coronary artery.
Diagnose irregular heartbeats, also called arrhythmias, especially that
occur during exercise. An arrhythmia can cause the heart to beat too fast
or too slowly.
Learn if heart treatment is working, or decide on a treatment. If you've
already been diagnosed with a heart condition, a stress test can help
your healthcare team know if your treatment is working. The test results
also help your healthcare professional decide on the best treatment for you.
Check the heart before surgery. A stress test can help your healthcare
professionals determine if you are healthy enough to undergo surgery.
How to prepare for a stress test:
Do not eat the morning of the test. Typically, you will be instructed to
not eat after midnight the day of the stress test
Do not smoke the day of the stress test
If you are getting a nuclear stress test, do not ingest any caffeine (including
coffee, soda with caffeine, energy drink, or anything with chocolate)
for at least 12 hours before the test
Please take your medicines at the regularly prescribed times, unless told
beforehand by your healthcare provider or by the stress test staff not
to take a certain medication. Common medications that are held for a stress
test are beta-blockers (such as Metoprolol, Carvedilol, and Atenolol)
and calcium-channel blockers (such as Diltiazem and Verapamil)
If you use an inhaler for asthma or other breathing, bring it to the test.
Tell your healthcare team that you use an inhaler
Wear comfortable clothes and walking shoes
Talk to your diabetes care provider before the test if you need assistance
coordinating your meals and medications for test day
