Heart Disease:
Diagnosing Heart Disease: Stress Tests

Heart Disease (Coronary Artery Disease) Slideshow

• What is an exercise stress test?
• Why do I need an exercise stress test?
• What types of stress tests are there?
• How should I prepare for the exercise stress test?
• What if I have diabetes?
• What should I wear the day of the exercise stress test?
• What happens during the exercise stress test?

Stress tests are tests performed by a doctor and/or trained technician to determine the amount of stress that your heart can manage before developing either an abnormal rhythm or evidence of ischemia (not enough blood flow to the heart muscle). The most commonly performed stress test is the exercise stress test.

What Is an Exercise Stress Test?

The exercise stress test -- also called a stress test, exercise electrocardiogram, treadmill test, graded exercise test or stress ECG -- is a test used to provide information about how the heart responds to exertion. It usually involves walking on a treadmill or pedaling a stationary bike at increasing levels of difficulty, while your electrocardiogram , heart rate and blood pressure are monitored.

Why Do I Need a Stress Test?

Your doctor uses the stress test to:

• Determine if there is adequate blood flow to your heart during increasing levels of activity.
• Evaluate the effectiveness of your heart medications to control angina and ischemia.
• Determine the likelihood of having coronary heart disease and the need for further evaluation.
• Identify abnormal heart rhythms .
• Help you develop a safe exercise program.

What Types of Stress Tests Are There?

There are many different types of stress tests, including:

• Dobutamine or Adenosine Stress Test: This test is used in people who are unable to exercise. A drug is given to make the heart respond as if the person were exercising. This way the doctor can still determine how the heart responds to stress, but no exercise is required.
• Stress echocardiogram: An echocardiogram (often called "echo") is a graphic outline of the heart's movement. A stress echo can accurately visualize the motion of the heart's walls and pumping action when the heart is stressed; it may reveal a lack of blood flow that isn't always apparent on other heart tests.
• Thallium (nuclear) stress test: This test helps to determine which parts of the heart are healthy and function normally and which are not. Before exercising, a very small and harmless amount of radioactive substance is injected into the patient. Then the doctor uses a special camera to identify the rays emitted from the substance within the body; this produces clear pictures of the heart tissue on a monitor. Using this technique, the heart has "hot" and "cold" spots that indicate the areas of heart muscle damage present before, during and after exercise.

Preparation for these types of stress test will vary from preparation for the exercise stress test. Ask your doctor about any specific instructions.

Suggested Reading by Our Doctors

• Coronary Artery Bypass Graft - Read about heart bypass surgery (coronary artery bypass graft surgery, CABG) including how coronary artery disease is diagnosed, treated, recovery time, risks and complications, and the long term results after CABG.
• Congestive Heart Failure - Read about congestive heart failure symptoms like fatigue, abdomen, leg and ankle swelling, shortness of breath, sleeplessness, increased urination, nausea, abdominal pain, and decreased appetite.
• Echocardiogram - Information on Echocardiogram including why you would need one, the types of echocardiograms, how to prepare and what to expect.

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