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Stress Heart Test (Treadmill, Exercise ECG)

About

A stress test is part of routine cardiovascular screening. Even if you do not have any heart problems, you should have a cardiovascular examination at least once a year. A stress test is also known as an exercise stress test or stress ECG. It is used to collect information about the heart function especially during physical activity as this increases the oxygen demand and workload on the heart. Therefore any abnormalities in the heart function that may not otherwise be detectable becomes more evident during a stress test. It is recommended in patients who are suspected to be suffering from coronary artery disease or rhythmic disturbances. Typically a treadmill is used during this procedure but an stationary exercise bike is also suitable.

Stress Heart Test

Reasons For Doing A Stress Test

A doctor may request a stress test as part of routine screening in individuals who are at a high risk of heart disease. Alternatively, a stress test may be advised when there is suspicion of one or more of the following conditions:

  • Coronary artery disease where there is narrowing of the arteries supplying the heart muscles mainly due to accumulation of fatty plaques (atherosclerosis).
  • Arrhythmias where there is an abnormality of the heart rhythm characterized by fast heart beating or slow beating or fluttering.
  • For guiding current treatment practices in a patient who is already diagnosed with heart disease.
  • In some patients, a stress test helps to determine the appropriate timing for cardiac surgery especially with valve replacement surgery or in patients with longstanding heart failure who may now require heart transplantation.

The doctor may recommend a specific type of stress test known as nuclear stress test which unlike the conventional stress test helps to pinpoint the exact cause of cardiac symptoms. In this type stress test a radioactive dye is used and images of the heart are created using special type of scanner.

Preparing For The Test

A thorough medical, drug and family history is taken by the doctor. Details about regular physical activity also needs to be noted to determine the patient’s level of fitness and tolerance for exercise. Before the test the patient is usually advised to avoid eating, drinking or smoking for at least for two hours or more. Chronic drugs and other medication that are frequently used should not be stopped unless the doctor advises otherwise.Patients using inhalers for breathing problem should inform the doctor about it and carry the inhaler as it may be needed during the test.

Procedure

Electrodes are placed over the patient’s chest, arms and legs. The other end of the electrodes are connected to an electrocardiogram (ECG) machine which will monitor the electrical activity of the heart muscle.  The blood pressure is also constantly monitored by a BP machine with the cuff secured to the arm.

At first the patient walks on a treadmill or pedals slowly on a stationary bike. With time the speed of the treadmill or the resistance against which the patient pedals the bike increases. The patient is also asked to breathe through a tube so that the amount of different gases exhaled can be measured.

The duration of the test depends upon the person’s physical fitness levels. Usually about 8 to 12 minutes are required to monitor the heart function adequately. The test is continued until the heart rate reaches a certain level or the patient develops certain symptoms like chest pain, respiratory distress, dizziness or if abnormalities in the ECG are noted.

After completion of the test the patient is asked to stand still and then lie down until all the cardiac parameters are normalized.

References:

Stress test. Mayo Clinic


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