Stress Tests

Your doctor may suggest a stress test as a way to determine if you are at risk for coronary artery disease (blocked heart arteries), a variety of heart rhythm disorders, or to determine your heart’s overall tolerance to exercise. These tests are non-invasive and are performed in several different ways. A doctor will be present to supervise the stress portion of the exam. While there are several different ways of performing stress tests, your doctor will choose which type is most appropriate for you.

HOW DO YOU “STRESS” THE HEART?
  • Typically the preferred way to stress the heart is to use a treadmill which increases in height and speed every three minutes. If necessary your doctor can alter this to adjust to your individual needs.  The goal is to get the heart rate up to a “target heart rate” which varies with age.
  • Alternatively, if it is not possible for you to walk on a treadmill (for example, due to severe joint pain, etc.), or if you cannot get to your “target heart rate”, your doctor may choose to use a medicine to stress the heart. This is called a “pharmacologic stress”.
  • Medicines for pharmacologic stress tests include adenosine (Adenocard® and regadenosine (Lexiscan®), which open the arteries of the heart, while dobutamine (Dobutrex®) simply speeds up the heart rate. Your doctor will choose the most appropriate type depending on your individual circumstances which vary from patient to patient.
TYPES OF STRESS TESTS:
  • Standard Treadmill Exercise Stress Test

During this type of stress your heart rhythm will be recorded by EKG throughout the test while you walk on a treadmill. The treadmill increases in height and speed every three minutes. Changes in the recorded EKG pattern can help your cardiologist determine if there are any problems that may be present with the heart arteries or its electrical system.

  • Nuclear Stress Test

Your doctor will choose the method by which the heart will be “stressed”, either using a treadmill or a medicine. This type of stress test then has two parts:

  1. An EKG tracing will be recorded throughout the stress portion of the exam just the same as during a standard exercise tolerance exam. This again gives information about the possibility of blockages being present.
  2. Second, a radiotracer material will be injected into a small IV which is taken up by the heart for a temporary period of time.  This is done twice (both at rest and during the stress portion of the exam), and pictures are taken of the heart during both portions with a special camera.

The pictures at rest and stress are compared to one another and this gives your cardiologist information about the possibility of heart blockages being present as well as insight as to how well the heart is pumping.

WHAT TO EXPECT ON THE DAY OF YOUR STRESS TEST

We want you to be comfortable and well informed for your stress test so please do not hesitate to ask questions about your specific exam!

 

Standard Treadmill Exercise Stress Test:  

  • You should expect to spend about an hour at the office.
  • Several stickers will be attached to your chest so your heart rhythm can be monitored.
  • Wear comfortable walking shoes, preferably tennis shoes if you have any.

 

Nuclear Stress Test:

  • Remember not to eat anything after midnight and most importantly, do not drink any caffeine the morning of your nuclear stress test (it can interfere with the accuracy of the test).
  • You should expect to spend around 4 to 5 hours at the office since there are a few more steps to this exam. In addition the radiotracer material has to wear off in between the two phases of the exam to keep things accurate.
  • If you are having a nuclear stress where adenosine or regadenosine is being used to stress the heart, it is common for this medicine to cause temporary symptoms due to the way it works in the body. These may include; chest heaviness, shortness of breath and in some cases, a “queezy” feeling in the stomach

Don’t worry, it’s only temporary and most symptoms are gone within 2 to 4 minutes! We may offer you a caffeinated beverage which may help you feel better if symptoms last longer than usual.