When You Need to Have a Stress Test: A Patient Guide

A stress test is an objective way of determining your exertional capacity. It can be used for many reasons. By far the most common use is to assess the cause for a patient complaint such as chest pain or shortness of breath on exertion. Additional appropriate uses of stress tests occur after heart attack, angioplasty, or bypass surgery to assess safe exercise capacity, or prior to starting an exercise program for someone at high risk of problems. Such tests permit your doctor to design an appropriate regimen for you, to determine if your medications are at optimal level for your protection, or if you are at an unusually high risk for cardiovascular events.

If you have already been diagnosed with coronary heart disease (CAD), a stress test may enable the doctor to estimate the severity of the blockages. Likewise, if you have just undergone balloon angioplasty or bypass surgery, a stress test helps the doctors monitor the success of the procedure as well as determine an appropriate rehabilitation program for you.

What equipment is used? Will I be in pain?

The stress test involves performing a simple exercise (usually a treadmill, although in Europe a stationary bike is a popular method) while you are monitored using several devices. An ECG (electrocardiogram) records your heart's electrical activity through electrodes that are taped to your shoulders and chest. A blood pressure cuff is used to constantly monitor your blood pressure; it is similar to the one you have used in the doctor's office, and is painless. Monitoring takes place throughout the stress test. In some cases, depending upon the reasons for the stress test, you may be asked to where a mask (to check on your use of oxygen) or an echocardiogram might require a technician to use a transducer (an instrument that looks like a microphone) to record an echocardiogram during the test. If imaging is going to be done with radioisotopes, an intravenous line will be inserted prior to starting exercise. In the case of radioisotopic imaging, you will be asked to lie on a special table so that your heart can be scanned. Radioisotopic echocardiographic scanning are usually done if there is an abnormal baseline electrocardiogram, or a high likelihood of an abnormal test result. Often, in women who have a high likelihood of a false positive test scanning may be added to an ordinary stress test.

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