An exercise stress test helps determine how well your heart responds when working its hardest. It typically involves walking on a treadmill while hooked up to an EKG to monitor your heart’s activity.
Overview
The steps of a cardiac stress test
A cardiac stress test can help healthcare providers identify certain heart conditions.
What is a stress test?
A stress test is a very commonly performed test to learn:
- How well your heart pumps blood.
- Whether your heart is receiving an adequate blood supply.
- How do you perform physical activity (riding a treadmill or stationary bike) compared with other people your age and sex?
- If your symptoms (chest discomfort, shortness of breath, feeling like your heart is racing, or even dizziness) can be reproduced while performing physical activity.
- This makes it easier to identify and evaluate specific heart issues, such as:
- Issues with your muscles or valves.
- Adequate blood supply to your heart muscle.
- Electric stability of your heart at rest and during exercise.
- Cardiac stress tests help healthcare providers determine whether you need additional — often more invasive — testing to confirm a diagnosis or if treatment might lower your heart attack risk and make you feel better.
How does a stress test work?
A heart stress test starts by making your heart pump harder and faster. This includes walking on a treadmill for many people. That’s why the test is often called an exercise stress test.
Healthcare providers assess your response to the increased workload by measuring:
- Blood pressure.
- Heart rate.
- Oxygen levels.
- Electrical activity in your heart.
- How hard is your heart working compared with others, your age, and your sex?
- Why might I need a stress test?
You may need this test to detect heart problems like:
- Congenital heart disease.
- Congestive heart failure.
- Coronary artery disease.
- Heart valve disease.
- Hypertrophic cardiomyopathy.
- People with high-risk occupations (like pilots or professional athletes) may also need stress tests.
Who should have a cardiac stress test?
This test may be proper for you if you have symptoms of heart disease, such as:
- Angina is chest pain or discomfort due to poor blood flow to the heart.
- Arrhythmia is a rapid or irregular heartbeat.
- Shortness of breath (dyspnea).
- Feeling lightheaded or dizzy.
Stress tests are also for people with a heart disease diagnosis who:
- I want to start exercising.
- Are undergoing treatment, and healthcare providers need to determine how well it works.
- Face a higher risk of complications due to a personal or family history of heart disease.
- Have diabetes or other underlying conditions that increase your risk of heart disease.
- Require non-cardiac surgery, and healthcare providers need to assess your risk of complications.
Providers may also do stress tests in people without known heart disease or symptoms to assess their risk for heart disease and heart attacks, especially if they have other risk factors like diabetes, high blood pressure, high cholesterol, or a family history of premature heart disease.
What are the different types of stress tests?
There are many methods for assessing heart function while it’s working hard. All cardiac stress tests involve checking your heart rate, blood pressure, oxygen levels, and electrical activity, but some differences exist.
Nuclear stress test
This advanced heart stress test uses safe levels of a radioactive substance and a cardiac imaging scan to assess heart function. A healthcare provider takes pictures of your heart before (at rest) and after you exercise. A cardiologist compares the amount of blood flow to the muscle of your heart at rest and after stress. A decrease in blood flow signal usually indicates a blockage in one or multiple arteries in your heart.
Nuclear cardiac stress tests can:
- Determine the severity of blockage of coronary artery disease.
- Assess whether previous treatments, such as stents or bypass surgery, work as they should.
- Help you avoid more invasive heart tests, such as cardiac catheterization.
- Show whether your heart is healthy enough for non-cardiac surgery or exercise.
- Cardiac rehabilitation stress test
The program may include stress testing if your healthcare provider recommends cardiac rehabilitation. Rehabilitation is a medically supervised exercise program that helps people with heart disease become more physically active.
Cardiologists consider your overall health in determining whether a heart stress test is proper for you. This determination includes you:
- Age.
- Family history of heart disease.
- Sex.
Health history. - Level of physical activity.
- Symptoms.
- Risk factors include smoking, diabetes, high blood pressure, and high cholesterol.
Is cardiac stress testing safe?
If there are no contraindications, exercise stress tests are safe. Very few people experience complications. In the rare event of a complication, trained healthcare providers, typically exercise physiologists and cardiologists, are present during your test. They assess your performance, data, and symptoms throughout the tests and immediately provide emergency treatment if needed. Stop the stress test anytime if you become anxious or uncomfortable.
Test Details
How long is a stress test?
If you’re undergoing a basic stress test, the exercise lasts about 10 to 15 minutes. Additional time is necessary to prepare for the exercise and recover afterward.
How do I prepare for an exercise stress test?
To prepare, you should:
- Do not eat anything in the hours leading up to the test. If you’re having a nuclear stress test, you might not be able to eat until after your test.
- Avoid caffeine for 24 hours before testing. This includes coffee, tea, energy drinks, and certain over-the-counter medications.
Do not smoke or use tobacco products. - It would be best to stop taking certain prescription medications, including beta-blockers and asthma inhalers, on the day of your test. Talk to your healthcare provider before stopping any medicines.
- Try to relax. Being nervous about heart testing is natural, but feeling anxious can affect your results.
Wear lightweight, comfortable clothes and sturdy walking shoes.
Are there special preparations people with diabetes need to be aware of?
It’s important not to eat before your test. However, you shouldn’t skip meals, especially if you’re taking diabetes medications. Talk to your diabetes care provider if you need assistance coordinating your meals and medications for test day.
What happens during an exercise stress test?
Here’s what to expect during an exercise stress test:
- A technician takes your vital signs, including your resting heart rate and blood pressure.
- They attach small, sticky disks (electrodes) to your chest and arms. The electrodes connect to the EKG machine.
- You walk on a treadmill or pedal a stationary bicycle at a leisurely pace.
Over time, the pace becomes more intense but still manageable. - Technicians and exercise physiologists periodically ask how you are feeling.
- The test ends after maintaining your target heart rate long enough to capture readings about heart function, usually about 10 to 15 minutes. Your target heart rate is higher than at rest and based on your age and fitness level.
- Technicians may end the test early if you experience severe symptoms or ask to stop.
- How is a heart stress test different if I cannot exercise?
You receive medications through a vein in your arm (intravenously). The medications simulate the effects of exercise on your heart by making it pump harder and faster. It can take up to an hour to start feeling the effects.
Exercise stress tests will be offered at our three Nuclear Medicine facilities. Please call to inquire about scheduling 973-810-8100
Jefferson ( Coming Soon )
West Orange ( available In May 2024)
Woodbridge (Coming Soon )
