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The Cleveland Clinic

Heart Disease:
Diagnosing Heart Disease: Stress Tests

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.



Next: How should I prepare for the exercise stress test? »

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Exercise Stress Test

What is a heart attack?

A heart attack (also known as a myocardial infarction) is the death of heart muscle from the sudden blockage of a coronary artery by a blood clot. Coronary arteries are blood vessels that supply the heart muscle with blood and oxygen. Blockage of a coronary artery deprives the heart muscle of blood and oxygen,causing injury to the heart muscle. Injury to the heart muscle causes chest pain and chest pressure sensation. If blood flow is not restored to the heart muscle within 20 to 40 minutes, irreversible death of the heart muscle will begin to occur. Muscle continues to die for six to eight hours at which time the heart attack usually is "complete." The dead heart muscle is eventually replaced by scar tissue.

Approximately one million Americans suffer a heart attack each year. Four hundred thousand of them die as a result of their heart attack.

What causes a heart att...

Read the Heart Attack article »










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