Exercise Stress Test: Everything You Need to Know

Heart health is extremely important, and can be significantly impacted by stress. According to data from the CDC, about 610,000 people die of heart disease in the U.S. every year. That works out to about 1 in every 4 deaths annually, making it the number cause of death in the country.

One of the best ways to defend yourself against heart disease is with an exercise stress test. We’ve put together this guide packed full of everything you need to know about what exercise stress tests are, why you need them and everything in between.

What is an Exercise Stress Test?

This is a test that is performed to know how your heart works when it is under physical stress. It shows how much your heart can handle before it starts showing signs of an abnormal rhythm. The test is usually used by doctors to diagnose coronary heart disease and how severe it is.

When Should an Exercise Stress Test be Performed?

Doctors can recommend this test to patients for a number of reasons. Some of them include:

  • To determine if you are eligible to take part in an exercise program despite having heart disease or the risk factors that may lead to heart disease
  • If you are experiencing chest pain. This may be a sign of coronary heart disease (A condition where the flow of oxygen-rich blood to the heart muscle is reduced due to presence of fatty deposits known as plaque)
  • To determine how well your heart valves are working
  • You have frequent or worsening angina
  • You have undergone heart bypass surgery or angioplasty
  • To determine any abnormal rhythmic changes during the exercise
  • If you have ever had a heart attack
  • To check if the procedures done to improve coronary heart disease are effective or not

At times, you may want to take this test to know the state of your heart. However, it is not recommended that doctors give this test to those not showing any symptoms of heart disease.

How Exercise Stress Tests Work

Electrodes (small, flat patches) will be placed on your chest. They will also be attached to an electrocardiogram monitor which will read information about your electrical activity during the test.

As the electrodes on your chest are being prepared, you may feel a slight burning or stinging sensation. A blood pressure cuff which keep measuring your blood pressure throughout the physical activity will be placed on your arm.

As the cuff inflates, you may feel a bit uneasy due to the squeezing sensation produced in the measuring process. While still resting, your heart rate and blood pressure will be measured.

Afterwards, you will pedal on a stationery exercise bike or walk on a treadmill. The rate of activity will keep increasing gradually until you feel tired.

running on treadmill

During the exercise, you will be asked how you are feeling in order to determine if there are any unusual symptoms such as chest pain, being lightheaded, dizziness or shortness of breath among others. In addition to this, your breathing rate, blood pressure and heart rate will be checked on the monitor.

If there are any unusual signs that are dangerous, the exercise will be stopped.

After all the information has been gathered, the rate of physical activity will be reduced gradually until it comes to a halt. During this time, your blood pressure and heart rate will still be monitored until it returns to the normal range. The stress test usually lasts between 7 and 12 minutes.

How to Prepare for an Exercise Stress Test

To increase accuracy of the test, there are rules that patients are expected to follow before beginning the test. Some of them include:

  • Avoid eating or drinking anything containing caffeine at least 12 hours before the test.
  • Avoiding eating or drinking anything 4 hours before the test. Water is the only exception.
  • If you use an inhaler, bring it along on the day of the test just in case you require it after the exercise.
  • If you take medication for the heart, diabetes or other diseases may be required to take less or none of their medication before the test. You should inform your doctor of any medication you are currently using and you will be advised accordingly. This is done to ensure the medication does not interfere with the test results. Do not make any changes to your prescription instructions unless the doctor has authorized it.
  • Wear loose clothing and comfortable shoes which will allow you to exercise without any discomfort.

Precautions

During the test, care should be taken so that only the appropriate stress levels are ordered for you. For some patients, the normal stress levels can be too much for them. If you are in this category or you cannot exercise for one reason or another, another stress test is ordered.

The test will still increase your heart rate and your blood pressure will be monitored.

Risks

Generally, the test is safe. However, there is a small possibility you may faint or collapse. In very rare cases, an irregular heart rhythm or heart attack may be experienced.

Such cases are likely to occur if you already have a heart problem. If this is known beforehand, the exercise stress test will not be performed on you.

Exercise Stress Test Results

Normal Results

Normal results indicate that you have less than 70 percent artery blockage. However, there may be a chance of you suffering from a heart attack if a blockage occurs and a blood clot is formed.

Based on your results, certain risk factors may be identified. If this is the case with you, your doctor will perform additional tests for accuracy purposes and to get more information about your current heart condition.

Abnormal Results

These results indicate that you have artery blockage of 70 percent or higher. You are thus at a higher risk of developing a heart attack. Despite these results, the doctor will need to perform additional tests in order to confirm results of the exercise stress test. This is because the results may be a false alarm. No test can be 100 percent accurate.

Alternative Stress Tests

There are other tests that may be performed to determine whether you have coronary heart disease or not. These tests can be either confirmatory or alternative tests. Some of them include:

1. Adenosine Stress Test

A drug is administered to you to make your heart respond as if you are exercising. The test is usually performed on those who cannot exercise.

2. Nuclear Stress Test

It is done to determine which parts of the heart are not functioning normally. A radioactive substance is injected into your body and a special camera is used to see pictures of your heart tissue on a monitor.

3. Stress Echocardiogram

It monitors the hearts movement and displays results in form of a graphic outline. The test the how the walls of the heart move and the heart’s pumping action.

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