STRESS TEST
What is a Stress Test?
A stress test helps your doctor determine how well your heart handles an increased workload. By measuring blood flow to the heart, the test can reveal if you are at risk for a heart attack. The test is performed in a controlled environment where heart rate, rhythm and blood pressure are monitored throughout the duration of the test.
Why Are Stress Tests Needed?
Stress tests can help:
- Identify causes of chest pain, shortness of breath, dizziness and lightheadedness
- Check the effectiveness of certain procedures or treatments
- Create a safe exercise plan
- Identify any heart rhythm changes that are experienced during exercise
- Determine your risk of heart disease or other related conditions
When Should You Consider a Stress Test?
It’s important to note that your doctor may recommend a stress test for a variety of reasons. It is a good idea to ask your doctor about having a stress test if you:
- Are a smoker
- Have a family history of heart disease
- Have high blood pressure
- Have high cholesterol
- Have diabetes
- Are overweight
- Are experiencing chest pains
What Should I Expect During a Stress Test?
A technician will first monitor your blood flow while at rest, and then again as you exercise on a treadmill. If you cannot exercise, your doctor may give you a medication that makes your heart respond as if you were exercising. Once the test is complete, your doctor will compare the two test results and discuss with you how the results relate to your health.
What Are the Risks of Having a Stress Test?
An exercise stress test is noninvasive and very safe, involving minimal risk to a patient’s health. All stress tests are monitored by one or more medical professionals who will stop the test if:
- You develop chest pain
- Your blood pressure reaches a level of concern
- The ECG shows that your heart isn’t receiving enough oxygen
- You experience severe shortness of breath
- You have another symptom preventing you from finishing the test
How Do I Prepare for a Stress Test?
The doctors at Advanced Cardiovascular Specialists will provide complete instructions about stress test preparation, as well as a pre-test preparation timeline, but general tips include:
Nothing to eat or drink prior to your appointment
Check with your cardiologist and take appropriate medications
Avoid coffee or caffeine
Different Types of Stress Tests
There are a number of different stress test types available to help the physicians at Advanced Cardiovascular Specialists analyze heart health, function, and structure. Each patient who is referred for a stress test undergoes a full health history evaluation to determine which stress test is applicable to their health situation. Our physicians consider previous medical history, lifestyle, injuries, physical ability, and current heart health concerns to determine which stress test is the right fit. The stress tests used to assess heart health, structure, and function are generally grouped into two different categories, each with varying levels of testing. These two categories include Exercise Stress Tests and Pharmacological Stress Tests.
Exercise Stress Tests
Exercise stress tests involve inducing stress on the heart and body through natural means such as physical exercise. These stress tests often involve continuous monitoring of the patient while on a treadmill or stationary bike to analyze heart rate, blood pressure, oxygen levels, and other heart activity. The speed or level of exercise activity is dependent on the patient’s physical ability, with the goal of reaching 85% of the patient’s maximum heart rate.
Pharmacological Stress Tests
Pharmacological stress tests are used when a patient is unable to perform exercise activities due to physical abilities or health limitations. In these cases, medications such as adenosine or dobutamine are used to induce stress on the body and heart, mimicking a stress response similar to that of physical activity.
Nuclear Stress Test
A nuclear stress test, otherwise known as Myocardial Perfusion Imaging (MPI), can be performed as an exercise stress test or a pharmacological stress test. This test involves the same physical or pharmacological activities, with the introduction of a minute amount of radioactive solution that is injected into the bloodstream. The radioactive solution can be visualized by a gamma camera, with images taken before and after the induction of stress to evaluate blood flow and heart function. Nuclear Stress Tests are often used to detect coronary artery disease or areas of the heart or arteries with blood flow deficiencies.
What Results Mean For Patients
Stress test results give patients an indication of whether there may be underlying vascular or heart function issues. Normal results suggest that there are no health issues involving blood flow, whereas abnormal results can indicate issues with the heart, valves, arteries, or veins.
Follow-up Care After Abnormal Results
Abnormal results after a stress test can point to a variety of underlying vascular conditions that may require further diagnostic testing. Stress tests are hyper-sensitive and can vary widely based on the patient’s health history and physical ability, often giving false positive results. As a result, additional testing is often recommended following abnormal stress test results.
Are Stress Tests Covered By Insurance?
The cost of a stress test in the US can vary depending on the type of test to be administered. Exercise stress tests can involve minimal costs, with costs increasing for pharmacological stress tests and nuclear stress tests. Most major insurance providers cover some or all of the costs associated with stress tests. To find out if your insurance coverage applies to stress tests, it’s best to contact your insurance provider. If you are unsure about the test details, it is always best to speak with your ACS physician. We can provide all of the information regarding the stress test to be administered and even liaise with your insurance provider on your behalf.
FAQ’s
What type of stress test is the best?
While each stress test has its applicability, ACS believes that a test that naturally induces stress on the body (exercise) is the most effective way to evaluate heart health, function, and structure. We know that every situation is different, and overall health history and injuries can play a role; that’s why ACS offers both exercise and pharmacological stress tests to best serve our patients. A stress test that provides accurate insight into your heart health and function is the best type of stress test.
How fast do you have to go on a treadmill stress test?
There is no set treadmill speed involved with an exercise stress test. Rather, the goal of the treadmill stress test is to reach 85% of the maximum calculated heart rate of the patient. As everyone’s physical ability is different, treadmill speeds are dependent on the body’s ability to handle stress and can vary from patient to patient.
What does a stress test show that an echo doesn’t?
A stress test combined with an echo helps to show the heart in action, giving doctors an insight into how a patient’s heart performs under increased bodily stress.
How long is a stress test?
The length of a stress test can vary by patient ability, but generally takes up to one hour to complete. The exercise portion of a stress test, however, generally includes around 15 minutes of intensive exercise required to increase heart rate.
Can you still have heart issues if your echo is normal?
Yes, while echos are great tools for assessing heart structure and function, they do not detect all blockages and should be combined with other diagnostic testing when determining if heart intervention is required.
Medical Disclaimer
The medical information on this website should not be a substitute for physician consultation, diagnosis, or treatment. All content including text, images, and information contained on or through this site is provided for informational purposes only. You are encouraged to confirm information with other sources and review all information regarding medical conditions or treatments with your physician. Please consult your physician, or contact ACS for an appointment, before making any healthcare decisions regarding a specific condition or treatment.