A stress test is performed to diagnose and evaluate heart problems. It shows the performance of the heart during strain, and can help in diagnosing coronary artery disease, heart rhythm problems and can guide treatment for heart disorders. This test is often conducted while doing simple physical exercise, for example – running on a treadmill or riding a bicycle in the doctor’s office. In the meanwhile, a medical team records all the vitals like blood pressure, pulse rate, breathing and heart’s electrical activity.
Your doctor may advise a stress test if you have symptoms of heart problems like shortness of breath, chest pain, dizziness, irregular heartbeat, etc. It may also be recommended if your healthcare practitioner suspects heart disease or you are in an intermediate- or high-risk category. It also helps your doctor determine the right treatment plan for you, along with heart-safe physical activities.
Why is a Stress Test Performed?
Stress is performed to diagnose certain heart-related conditions. It is performed to:
- Diagnose coronary artery disease (Blockage in heart’s arteries)
- Diagnose heart rhythm problems (Abnormal heart beat)
- Make decisions about heart treatment
What are the Conditions in Which a Stress Test is Performed?
A stress test is performed to evaluate:
Ischemic heart disease
Ischemic heart disease is a heart condition where a section (or sections) of the heart does not receive sufficient amounts of blood. This condition occurs when the arteries get blocked by cholesterol and the blood flow gets restricted. The symptoms of ischemic heart disease are chest pain and shortness of breath. Some people may not show any symptoms at all.
Heart valve disease
The human heart has four valves. They are responsible for monitoring the direction of blood flow. Heart valve disease is caused when one or more of these valves do not work properly. Symptoms of heart valve disease include chest pain, fatigue, dizziness, fainting, and irregular heartbeat.
Heart failure is also known as congestive heart failure. It is caused when the heart muscles fail to pump blood properly. It is caused by high blood pressure and clogged arteries. Heart failure symptoms include fatigue and weakness, swelling, shortness of breath, rapid and irregular heartbeat, lack of appetite and nausea, etc.
Types of Stress Tests
Stress ECG (Electrocardiogram) testing
Stress ECG is the most basic and common type of stress test. In this type of stress test, a medical team in resting and exercising modes will monitor your ECG. The nursing staff will connect painless electrodes to your body. They will also attach a blood pressure machine to monitor the changes as you go from sitting to running on a treadmill or bicycling.
The process starts with a resting ECG, and then you will be asked to move to a treadmill or a bicycle. The medical staff will keep an eye on the changes in your heartbeat, blood pressure, and other statistics as you start to work harder. This is the time when you may experience some symptoms that you have to share with the team because it is vital information for them.
A stress ECG may be recommended for assessing heart damage, diagnosing CAD, arrhythmias, and valve disease. It also provides information that helps in decisions like type and time of heart surgery.
Stress echo testing
Stress Echo Testing is also known as Stress Echocardiogram. This testing uses ultrasound imaging. The process starts with the medical staff taking an ultrasound image of the heart at rest. The next image is taken either after the stress exercise or after the administration of heart stimulation medicine.
A stress echo test is conducted to look at the structures inside the heart. It also helps in checking the heart muscles with poor blood flow and dead tissues. During a stress echo testing, a physician can observe the heart and compare the motion of the heart before and after the stress test. This test is efficient in identifying blockages and other problems in the heart.
Nuclear stress testing
Nuclear Stress Testing works with the help of a radioactive tracer solution. In this process, you will be administered an intravenous radioactive solution that releases gamma rays that can be detected by a special camera. This process provides the medical team with a clear image of the heart. The tracer solution is picked up by healthy heart cells, so they appear clearly on the image. Whereas, it is not picked by the dead tissues and heart cells with poor blood flow.
Nuclear stress testing is also known as MPI, which stands for Myocardial Perfusion Imaging. This process is complex as compared to other methods; hence, the results may take longer but it is considered more accurate. Nuclear stress testing can find even the smallest changes in blood flow, along with severe blockages.
How to Prepare for a Stress Test
Prior to the stress test, your physician may perform a thorough physical examination and analyze your medical history.
Before the stress test
If you have any health issues that may make exercising difficult, such as arthritis, you will have to inform your doctor before the stress test is scheduled. Before taking the test, your doctor may stop prescription medicines and you may be asked not to have a heavy meal just before the test.
During the stress test
A medical team will attach the electrodes to your chest and will also place a pressure cuff on the arm. A pulse monitor will be placed on your finger to count your heartbeat. Once the setup is ready, you will be asked to start exercising on a treadmill or a stationary bicycle. Your speed will be increased gradually till your heart reaches the ideal heart rate recommended for your age. Your test will be stopped if your vitals show signs of distress. If you cannot exercise, you may be given medicine to increase your heart rate to the target levels.
After the stress test
Once the test is over, your medical team will measure your blood pressure and heart activity till they come back to the normal range. If there are no health issues, you will be expected to get back to normal almost immediately, and you will not require any more diagnostic tests. You may be recommended more tests if the stress test indicates a heart problem, if your symptoms do not go away or if your heartbeat rate does not come back to normal even after resting.
Some doctors recommend yearly stress tests even for healthy adults. You should get them along with other annual tests to ensure that your heart health issues are diagnosed in time. If you have risk factors associated with heart health, you should go for a stress test whenever your doctor recommends it. Are you concerned about your symptoms? Do you want to speak with a highly-experienced cardiologist?
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Frequently Asked Questions (FAQs)
● Can a stress test show a heart vessel blockage?
A stress test can detect clinically significant blockages of heart arteries, which is 70% or more.
● What is a positive stress test?
A stress test is said to be positive or abnormal if there is evidence of heart disease .
● Can a stress test incite a heart attack?
Although extremely rare, a stress test might induce a heart attack. This is the reason why a patient is closely monitored during the test.