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Noninvasive Cardiology

Exercise Stress Testing
A stress test, sometimes called a treadmill or an exercise test, helps your doctor see how well your heart works during physical activity.

As your body works harder during the test, it needs more oxygen and energy. To meet this demand the heart must beat faster and harder. The test shows if your heart gets enough blood from its own arteries to work harder, safely. Taking the stress test also helps your doctor know what type of exercise and how much is right for you.

The basic stress test requires leads on the chest to provide the signal. The electrocardiogram is the electrical signal the doctor monitors during the test. The doctor monitors your heart rate, heart rhythm, and looks for changes which suggest that the heart itself is not receiving enough blood. They will record an electrocardiogram at rest, at peak exercise, and afterwards. He/she will also check your blood pressure before, during and after the test. The doctor will ask about symptoms and how tired you feel.

Initially the test starts slowly. With time the speed or incline (hill) may increase. You can stop the test at any time if you need to. You are encouraged to do the best you can but not to hide symptoms. After the test you may sit or lie down while the doctor continues to monitor your heart rate, ECG, and blood pressure.

Common Questions Asked About Stress Testing

Is it safe?
There is little risk and medical professionals are present to respond to any unusual happening.

Will I need other tests?
The results of the exercise test may suggest to your doctor that you need further studies or eliminate the need for further studies.

What should I wear?
Comfortable clothing and shoes.

How long will it take?
Routine stress testing takes about an hour. If images are required, the test can take about 90 minutes. Usually, you must return for more pictures 3-4 hours later, so the entire test with images can take 5 hours.

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Types of Stress Testing
You may need other types of stress tests. Your doctor will decide which test is best for you. These other stress tests may use a treadmill or bicycle. The type of pictures the doctor wants to see determines which test they will pick.
Images of heart's blood supply:
Perfusion imaging

1. Thallium-201 stress test
2. Technetium-99m sestamibi stress test

Images of how the heart works
Functional imaging

1. First pass exercise test
2. Echocardiographic stress test

Images of both types
1. Technetium-99m sestamibi stress test.
If a patient cannot walk adequately on a treadmill, the doctor may request a stress test without exercise. Certain drugs, such as persantine and dobutamine can stimulate the heart adequately to obtain satisfactory pictures of the heart in action.

Exercise Stress Echocardiography
An exercise stress echocardiography is a test that shows the activity of the heart during exercise. It may also be called exercise echo or stress echo. This test shows how well your heart can handle stress. Exercise is a form of body stress. The longer you exercise, the harder your body needs to work.

An exercise stress echocardiography uses sound waves to make images of the heart before, during, and after the exercise. Images at rest are compared with those during and after exercise to know how the heart responds to exercise. There are times when arteries of the heart get blocked and its muscles get damaged. When this happens, the heart must work even harder to supply oxygen-rich blood to the body. The damage or blockage may be seen when an exercise echo is done.