Stress Testing

Contents:

• What is an Exercise Stress Test?

• Adenosine or Dobutamine Stress Testing

• Preparation for Nuclear Stress and Adenosine Stress Tests

A stress test, sometimes called a treadmill test or exercise test, helps physicians find out how well the heart handles work. As the body works harder during the test, it requires more oxygen to meet the increased metabolic demands of exercise.  The electrocardiogram (ECG) is monitored continuously during the test to watch for any changes that suggest ischemia-- an insufficient delivery of oxygen to the working heart muscle.  Exercise stress testing is tremendously informative in screening for coronary artery disease as well as periodically following known heart disease.  An individual’s capacity to perform higher degrees of exercise (functional capacity)  provides your doctor with important prognostic information.  In general, as an individual’s exercise capacity increases, so do the odds that he or she will be free of major adverse cardiac events (heart attack, etc…) over the ensuing year.

Stress Testing is used to prescribe exercise regimens for inactive persons who plan to begin a tailored exercise program.  It's also scheduled after bypass surgery (CABG), angioplasty and following a heart attack, in preparation for a cardiac rehabilitation program.

Often, a Stress Test will be combined with Nuclear Imaging (Cardiolyte Scan) or with an echocardiogram (Stress Echo) to improve the accuracy of the results and provide additional information about the structure and strength of the heart.

A person taking the test...

• Undergoes careful monitoring of the ECG and blood pressure.
• Walks slowly in place on a treadmill.
• Every few minutes, the speed and incline increase gradually.
• Can ask to stop the test at any time if necessary.
• Will be monitored carefully following the test until vital signs have returned to baseline

The risk from a careful stress test is exceedingly small.  Medical professionals including a technician trained in exercise physiology supervise the test, and a cardiologist is immediately available.

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Many patients cannot undergo traditional Treadmill Stress due to physical limitations such as arthritis, deconditioning, and disease of the leg arteries (peripheral arterial disease).  Other patients have changes in their electrocardiograms (ECG’s) caused by pacemakers and heart disease that would likely result in uninformative or erroneous information from a Treadmill Stress.When a stress test is indicated in such patients, medicines such as Adenosine and Thallium will be used to simulate the effects of exercise on the heart.  For more information please refer to the following links: 

Adenosine Nuclear Stress Test  

Preparation for Stress Testing.

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