Cardiac Stress Test: What to Know and How to Prepare

A cardiac stress test is a diagnostic tool to evaluate the heart’s response to physical or chemical stress. It involves monitoring the heart while the patient exercises, usually on a treadmill or stationary bike. The primary purpose of a cardiac stress test is to identify potential heart conditions such as significant coronary artery disease, severe valvular dysfunction and other cardiovascular issues that may not be noticeable when the body is at rest. By increasing the heart’s workload, doctors can observe how well the heart pumps blood and identify any irregularities in the vessels that supply blood to your heart.

What are the types of cardiac stress tests?

There are two primary ways to stress the heart for diagnostic purposes: exercise or medication.

Exercise stress test	The most common type of cardiac stress test. The exercise stress test requires patients to walk on a treadmill or pedal a stationary bike while healthcare providers monitor heart function. Doctors may use imaging tests, such as a cardiac ultrasound, right after exercise to ensure an accurate diagnosis. This procedure is called an exercise stress echocardiogram.
Pharmacological stress test	For those unable to exercise, a pharmacological stress test is an alternative. Medications mimic the effects of exercise on the heart. Afterward, a small amount of radiotracer is injected into the bloodstream, and a special camera is used to look for any evidence of coronary blockage. The two main types of this test are a SPECT or PET stress test.

How do you prepare for a cardiac stress test?

Preparation for a cardiac stress test is straightforward but essential for accurate results. Here are the key steps:

Consultation: Discuss your medical history, medications and any symptoms with your doctor.
Instructions: Follow specific instructions your healthcare provider gives, such as dietary restrictions and medication adjustments.
Fasting: Your doctor may advise you to avoid eating or drinking for a certain period before the test.

Your doctor may ask you to avoid certain medications or foods before the test, as they can affect the results. Common restrictions include:

Medications: Under your doctor's guidance, you may need to pause some heart medications.
Caffeine: Avoid caffeine 24 hours before the test, as it can interfere with results.
Food and drink: Refrain from eating or drinking for a few hours before the test to ensure accurate readings.

What to wear to a cardiac stress test?

Wear comfortable, loose-fitting clothing and sturdy walking shoes suitable for exercise. The entire appointment, including preparation and recovery time, should last approximately an hour.

What happens during a cardiac stress test?

The cardiac stress test has two parts: exercise and monitoring. Before the exercise phase starts, healthcare providers take baseline measurements of your heart rate, blood pressure and EKG. These measurements serve as a reference point for comparison with values obtained during and after exercise.

The exercise phase: If you’re undergoing an exercise stress test, you will start walking on a treadmill or pedaling a stationary bike. The activity intensity gradually increases, with the treadmill speeding up or the bike resistance becoming more challenging. This allows healthcare professionals to evaluate how your heart responds to escalating exertion levels.
The pharmacological stress test: The pharmacological stress test involves administering medications to simulate physical activity. Following this, imaging tests capture detailed views of your heart to assess blood flow and detect potential issues.

Throughout the test, medical staff will monitor your heart’s electrical activity, blood pressure and any symptoms you may experience. It is critical to communicate any discomfort, such as:

Chest pain
Shortness of breath
Dizziness
Unusual heart rhythms

How to understand your cardiac stress test results

The results of a cardiac stress test can reveal various aspects of heart health, such as:

Coronary blood flow: Abnormalities in blood flow may indicate blockages or narrowing of the coronary arteries.
Heart function: The test assesses how well your heart pumps blood under stress, helping to identify heart failure or other functional issues.
Valvular conditions: Sometimes, a heart valve problem can be shown to be worse with stress, indicating the need for valve replacement or repair. Your physician will contact you promptly to discuss the next steps for your healthcare.

Next steps after a cardiac stress test

Your doctor may recommend follow-up procedures, such as coronary angiography, depending on the findings. Treatment options might vary and could include:

Lifestyle changes: Adopting a heart-healthy diet, increasing physical activity, quitting smoking, and managing stress.
Medications: Prescriptions like beta-blockers or other heart medications might be necessary.
Surgical interventions: Doctors may recommend procedures such as angioplasty or bypass surgery to restore proper blood flow and improve heart function.

A cardiac stress test is important in the evaluation of chest pain, assessing heart health and guiding treatment decisions. By understanding the process and working closely with your physician to select the most appropriate test for your needs, you can take proactive steps to effectively manage your heart health.

Take the first step towards a healthy heart and schedule an appoint with a cardiologist today!