A cardiac stress test is the recording of the heart's activity while you exercise. Your heart is monitored by using electrodes to record the electrical activity it makes. Your heart's activity will also be monitored by seeing how your blood pressure and pulse change over the course of the test.
During physical activity, the body needs higher levels of oxygen, which it gets from blood. To get the blood to the organs faster during exercise, the heart has to work harder. A cardiac stress test is used to see if your heart still works well, even when it is working hard. The test is most often done:
A cardiac stress test presents minimal risk. Complications can include:
Technicians are alert for any signs of heart or lung problems. They are prepared to take immediate action if complications develop. A doctor (usually a cardiologist) will be readily available during the stress test as well.
Your doctor may do the following:
In the time leading up to your procedure:
ECG electrodes will be attached to your chest. The electrodes are small, sticky patches with wires. Your resting blood pressure and ECG readings will be taken.
The cardiac stress test is done on a treadmill (most common) or a stationary bike. You will slowly start walking or riding. At regular intervals, the speed and elevation will be increased. Your ECG, blood pressure, heart rate, and symptoms will be closely monitored.
The test may be stopped early if you feel extremely tired, get chest pain, have trouble breathing, or have any symptoms that suggest heart problems. Significant changes in the ECG will also stop the test. After exercise is complete, your blood pressure, heart rate, and ECG will be monitored until levels return to normal.
A doctor may also order a blood-flow imaging exam, called a nuclear stress test. A small amount of radioactive chemical will be injected into a vein when you are exercising at your peak. Scans will be taken while you lie in different positions under a special camera. The images will help to identify areas of the heart muscle that may not be receiving enough oxygen. A second set of images will be taken about an hour later, after you have rested.
A stress echocardiogram may also be done. This is an ultrasound to take pictures of the heart before and immediately after exercise.
You may resume normal activities.
The exercise portion of the test generally takes less than 15 minutes. Your entire appointment will last about an hour. A nuclear stress test may take up to 3-4 hours.
Exercise testing normally causes no pain.
A cardiologist will review the test results and send a report to your doctor. The report is often sent within 24 hours.
One or more of the following are considered a positive stress test:
A positive test may mean CHD, but not all patients who test positive have CHD. Based on the results of the test, your doctor will decide if further testing or treatment is needed.
RESOURCES:
American Academy of Family Physicians
http://www.aafp.org/
American Heart Association
http://www.americanheart.org/
CANADIAN RESOURCES:
Canadian Cardiovascular Society
http://www.ccs.ca/
Heart and Stroke Foundation of Canada
http://ww2.heartandstroke.ca/
References:
Exercise Stress Test. American Heart Association website. Available at: http://www.americanheart.org/presenter.jhtml?identifier=4568. Accessed June 12, 2008.
Tierny LM, McPhee SJ, Papadakis MA. Current Medical Diagnosis and Treatment. 45th ed. New York, NY: McGraw-Hill; 2006.
Last reviewed November 2009 by Craig Clark, DO, FACC, FAHA, FASE
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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