Stress Tests
Stress tests evaluate how well your heart functions under physical exertion or simulated stress to help diagnose heart conditions and determine appropriate treatment.
What are stress tests?
Stress tests measure heart performance when it is pumping hard. Because some heart diseases are more detectable during peak activity, these tests monitor your heart while you exercise on a treadmill or stationary bicycle. If you cannot exercise, medication is used to simulate the effect of exercise on your heart.
All stress tests monitor:
- Blood flow in the heart
- Blood pressure
- Heart rate and rhythm
- Electrical signal strength
What are they used for?
Stress tests are used to find the cause of heart-related symptoms and diagnose conditions such as:
- Coronary artery disease (CAD)
- Angina
- Arrhythmia
- Heart failure
- Heart valve diseases
- Cardiomyopathy
They are also used to assess the severity of known heart conditions, guide treatment decisions, and evaluate heart strength before surgery.
Why do I need a stress test?
You may need a stress test if you experience chest pain, shortness of breath, irregular heartbeats, or dizziness. They are also used for patients with high risk factors for heart disease, those undergoing treatment for heart conditions, or individuals planning to start a new, strenuous exercise program.
What happens during a stress test?
During the test, you will have a blood pressure cuff on your arm and electrodes placed on your body for an electrocardiogram (EKG or ECG) to record electrical activity. If you are exercising, you will walk on a treadmill or ride a stationary bike until you reach a target heart rate, unless symptoms occur. If you cannot exercise, medication will be administered via an IV to increase your heart rate.
Stress Tests with Imaging
- Stress echocardiogram: Uses ultrasound to take moving pictures of your heart before and after exertion.
- Nuclear stress test: Uses a small amount of a radioactive "tracer" injected into the bloodstream to create clearer images of the heart.
- Cardiac MRI stress test: Uses radio waves, magnets, and a computer to create highly detailed images, sometimes involving the injection of dye.
Will I need to do anything to prepare for the test?
Wear comfortable clothing and shoes. You will typically need to fast and avoid smoking for several hours before the test. You may also need to avoid caffeine. Consult your provider regarding your current medications. If you are having an MRI, inform your provider about any metal in your body.
Are there any risks to the test?
Stress tests are generally safe and closely monitored. Potential risks include symptoms like chest pain or dizziness caused by the stress-inducing medication, or rare allergic reactions to tracers or dyes. An IV may cause bruising.
What do the results mean?
A normal result indicates no blood flow problems and good heart function. An abnormal result may suggest heart disease, requiring further testing to determine the severity and appropriate treatment plan.