Stress Test

What is an Exercise Stress Test?

An exercise stress test is done while you walk on a treadmill or pedal a stationary bicycle to learn how well your heart functions when it is made to work harder. This test can help detect heart problems that may not be apparent at rest. During the test, an electrocardiogram (ECG or EKG) records the electrical activity of your heart and your heart rate. Other terms used to describe the exercise stress test include: cardiac stress test, exercise tolerance test, and treadmill test.

What does the test show?

An exercise stress test is performed to evaluate the function of your heart when it is under stress (i.e., when it is made to work harder). This test can help evaluate the following:

• Your risk for coronary artery disease
• Whether the symptoms you are experiencing (i.e., chest pain or pressure, shortness of breath, unexplained fatigue, palpitations, lightheadedness, etc.) are caused by a blockage to your heart or other heart condition.
• It can help detect heart problems that may not be apparent at rest.
• It is used for cardiac clearance before a surgery or other procedure.
• If you have already been diagnosed with coronary heart disease, a stress test may enable the doctor to estimate the severity of the blockages.
• If you have just undergone balloon angioplasty or bypass surgery, a stress test can help monitor the success of the procedure as well as determine an appropriate rehabilitation program for you.

How do I prepare for the test?

• Do not eat or drink for 2 hours prior to the test. This will help prevent the possibility of nausea and vomiting which may accompany vigorous exercise after eating. If you are diabetic or need to eat/drink with your medication, get special instructions from your doctor.
• Avoid any strenuous physical activity on the day of the test because you will need to exert yourself maximally.
• No smoking 2 hours prior to the test. Smoking may interfere with the test results.
• Wear loose and comfortable clothing and shoes that are suitable for exercise
• Do not wear oils or lotions before your test. Small sticky patches (electrodes) will need to stick to your chest.
• Take your medications as prescribed unless your doctor has given you special instructions.

What happens during the test?

When you enter the stress testing room, the Cardiology Tech/Nurse will have you sign a consent form and he/she will make sure you understand the test. Your skin will be cleaned with a prep solution to clean off any oils or lotions. You will be shaven if you have a hairy chest. Ten patches are placed on your chest and torso. A belt with wires will be attached to the patches in order to hook you up to the EKG machine. The EKG allows the doctors and Cardiology Tech/Nurse to monitor your heart rate and rhythm. The Cardio Tech/Nurse will take your resting blood pressure and EKG while you are lying down and while you are standing. The Cardiologist will enter the room before you begin exercising. When the Cardiologist enters the room, he/she will perform a quick assessment and review your medical history.

You will step on the belt and hold onto the handrail before you begin walking on the treadmill. Once the treadmill belt starts, the speed and the grade will increase every 3 minutes. Most patients walk between 6 and 12 minutes. However, the treadmill test can last longer than 12 minutes depending on whether or not you are able to exercise longer. Your blood pressure, EKG and heart rate will be monitored continuously throughout the test. The treadmill test will stop when:

• You get too tired to continue
• You exceed a "target" heart rate based on your age
• The Cardiologist or Cardio Tech/Nurse detects abnormal changes on your EKG
• You experience symptoms, such as shortness of breath, chest pain, chest tightness, dizziness, etc. that do not permit you to exercise any longer.
• Your blood pressure goes up too high
  After the exercise portion of the test is over, you will be helped to a stretcher. Your blood pressure and EKG will be monitored for another 5 to 10 minutes while you recover.

When do I get the results and what do they mean?

The Cardiologist conducting the test may be able to give you preliminary test results before you leave the testing room. A test report will be sent to your primary Physician in about 3-5 business days. Or, your own Physician will discuss the test results with you during a future office visit.
If your test is positive (abnormal), the Cardiologist conducting the test, along with your Physician, will help develop a treatment plan that is best for you. The Cardiologist may recommend a more sensitive stress test…link to nuclear and echo. Or, the Cardiologist may recommend further, more invasive testing such as a cardiac cath.

If you have a negative test (no abnormalities) it is likely that your risk of coronary artery disease is low. Stress tests are able to detect individuals with heart disease about 70% of the time. This means that, if you actually DO have heart disease, the test will accurately detect it seven out of ten times.

It should be noted that the stress test is not wholly reliable. Sometimes the results are "falsely positive" meaning that there is actually no risk of heart disease despite the test's positive results. False positive results occur more frequently in women. Further testing will be necessary to determine whether you actually have heart disease.

If you are concerned about the validity of the ECG test, you may wish to discuss it with your doctor at greater length. You will not be diagnosed with coronary artery disease simply from the results of a stress test.

Is the test safe?

The exercise stress test is generally safe. There are risks involved because it stresses the heart. Possible rare complications include inducing an abnormal heart rhythm and causing a heart attack. Our staff is trained to handle any emergency.

Where is the test performed?

On the second floor of Sparrow Hospital in the cardiology department Heart Center or on the third floor of the St. Lawrence Campus.

How long does this test take?

A stress test varies in length depending on how long it takes to reach your optimum heart rate, and whether or not the test is terminated early due to fatigue, shortness of breath or chest pain. Usually, if the test is completed without a stoppage, it takes about 30 minutes: