Stress testing

This test is noninvasive, generally safe and may be performed with a simple treadmill exercise, echocardiography, or nuclear imaging techniques. Another type of stress test uses drugs instead of physical activity to produce the effects of exercise during the examination.

A Beverly Hills heart doctor may recommend an exercise stress test for a number of reasons:

  • To diagnose conditions such as coronary artery disease (a chronic disease in which there is a “hardening” or atherosclerosis of the arteries) in patients with chest pain.
  • To diagnose a heart-related cause of symptoms such as chest pain, shortness of breath or lightheadedness.
  • To determine a safe level of exercise among heart patients who wish to increase their level of physical activity.
  • To screen for coronary artery disease in some patients who do not have symptoms.
  • To evaluate the effectiveness of a balloon angioplasty (a procedure in which plaque in the arteries is pushed back against the artery walls to make more room for blood flow), or other procedures.
  • To predict future risk of dangerous heart-related conditions, such as heart attack.

 

 

Treadmill Exercise

The treadmill test is an electrocardiogram (ECG) that is done while you are walking on a moving treadmill with gradually increasing speed and/or grade (incline). Abnormalities in your heart rate and/or rhythm can be detected. This test is designed to determine if there is any problem with the blood flow through the coronary arteries that supply the heart with blood. The test will take approximately 1 hour.

 

Exercise Nuclear Perfusion Imaging

 

This test involves the patient exercising on a treadmill while an EKG records the heart’s response to physical activity. During a nuclear stress test, a radioactive substance is injected into the bloodstream test in order to determine which parts of the heart are healthy and receive adequate blood supply and which are not.  A special scanner is used to detect this substance and capture images of the heart muscle as the patient exercises. A nuclear stress test is more accurate than the standard stress EKG test and can provide physicians with additional information. The test will take approximately 3 to 4 hours.

 

Pharmacologic Exercise Nuclear Perfusion Imaging (Adenosine)

 

For patients who are unable to exercise adequately on the treadmill, the drug adenosine may be given to stimulate the effects on the heart similar to exercise. You will be given a break before having your second scan under the nuclear camera. Please do not leave the area until you have been instructed that your test has been completed. The test will take approximately 3 to 4 hours.

Exercise Echocardiogram

A treadmill test is performed and abnormalities in your heart rate and/or rhythm can be detected via continuous EKG evaluation. An Echocardiogram is performed to take pictures of the heart before and after exercise on the treadmill. This test is designed to determine if there is any problem with the blood flow through the coronary arteries that supply the heart with blood. The test will take approximately 1 hour.

 

PATIENT INSTRUCTIONS FOR STRESS TESTING

  • Please arrive 20 minutes prior to your scheduled test time.
  • Do not eat or drink for four hours prior to the test. The pictures of your heart are clearer when the stomach is not full.
  • Do not ingest any stimulants for 24 hours BEFORE the test. This includes coffee, tea, cola drinks, or chocolate.
  • If you are diabetic or need to eat/drink with your medication, get special instructions from your doctor. You may eat a light breakfast (cereal, toast, juice) the morning of the exam. NO CAFFEINE.
  • Wear comfortable clothing and walking shoes, such as tennis shoes. DO NOT WEAR OPEN-TOED OR OPEN-HEELED SHOES.
  • Do not wear necklaces or clothing with metal on it (metal buttons, sequins, brooches, etc.).
  • No smoking four hours prior to the test. Smoking may interfere with the test results. (You shouldn’t be smoking anyway!)
  • If you have asthma presently or previously, bring your inhaler(s) with you.
  • Bring a list of your medications with you.
  • Take your usual morning medications on the day of your test unless directed by your physician.
  • If you have been instructed to decrease your medication, be aware you may experience a transient increase in your blood pressure and/or palpitations.