Understanding Stress Tests: Types, Indications, and Procedure

Cardiology | by Dr. Rakesh Sarkar | Published on 15/05/2023

Overview: What Is A Stress Test?

Stress has become an integral part of our lives in today's fast-paced world. While a certain level of stress can be motivating, excessive and prolonged stress can have effects on our health, particularly our cardiovascular system. 

Stress tests, also known as exercise tolerance tests or cardiac stress tests, are medical procedures used to evaluate how well the heart functions under physical stress. This blog contains information about different types of stress tests, when they are needed, and the steps involved in the procedure. However, please note that this blog is only for informational purposes and does not replicate the significance of a doctor’s consultation. 

When Is A Stress Test Recommended?

Stress tests are recommended in several situations to evaluate the heart's function and diagnose potential cardiovascular problems. Certain signs can indicate the need for a stress test such as - 

• Chest pain or discomfort If a patient experiences chest pain or discomfort, a stress test can help determine if the symptoms are related to the heart and if further evaluation or treatment is required.
• Evaluating heart disease - Stress tests are used to assess the presence and severity of coronary artery disease, which is caused by the narrowing or blockage of the arteries that supply blood to the heart muscle.
• Assessing treatment effectiveness - Stress tests can be used to evaluate the effectiveness of medications, interventions, or lifestyle changes in managing heart conditions.
• Post-treatment evaluation After a heart attack, coronary artery bypass surgery, or angioplasty, stress tests may be performed to assess the success of the procedure and the patient's readiness to resume normal activities.

What Are The Different Types Of Stress Tests?

If you have symptoms of coronary heart disease, the doctor can offer several types of stress tests to determine the primary cause of the disease. Here are some types of stress tests -

• Exercise Stress Test - This is the most common type of stress test. During an exercise stress test, the patient is asked to walk or run on a treadmill or pedal on an exercise bicycle while connected to an electrocardiogram (ECG) machine. The speed and incline of the exercise are gradually increased to raise the heart rate and mimic the stress of physical activity.
• Nuclear Stress Test In a nuclear stress test, a small amount of a radioactive substance is injected into the bloodstream. This substance helps create images of blood flow to the heart muscle. The patient exercises on a treadmill or receives a medication that stimulates the heart, and then a special camera detects the radioactive substance in the heart.
• Stress Echocardiogram - This test combines an exercise stress test with an echocardiogram (ultrasound of the heart). It involves obtaining images of the heart before and immediately after exercise to evaluate changes in blood flow and heart function.
• Pharmacological Stress Test This type of stress test is performed on patients who cannot exercise. Instead of physical exercise, medications are used to stimulate the heart and mimic the effects of exercise.

What Signs Indicate The Need For A Stress Test?

Several symptoms of heart conditions can indicate the need for stress tests. Doctors generally recommend the test to evaluate the heart condition and help identify the primary cause of the disease. Here are some signs of cardiac disorders which can indicate the need for stress tests - 

• Angina (chest pain or discomfort) due to poor blood flow to the heart
• Arrhythmia (rapid or irregular heartbeat)
• Shortness of breath (dyspnea)
• Feeling lightheaded or dizzy

Stress tests are also recommended for people who are diagnosed with heart disease and - 

• Undergoing treatment and the doctor needs to determine its efficiency
• Increased risk of complications due to a personal or family history of heart disease
• Have diabetes or other underlying conditions that can increase the risk of heart disease
• Requires non-cardiac surgery and healthcare providers need to assess your risk of complications

How Is A Stress Test Performed?

Before the test, your doctor may provide you with tips and measures to help you prepare before the procedure. Here are some steps involved during the stress test -

• Preparation - Before the stress test, the patient's medical history and current medications will be reviewed. It's important to inform the healthcare provider about any pre-existing conditions or concerns.
• Electrode Placement - Electrodes will be attached to the patient's chest, arms, and legs to record the electrical activity of the heart during the test. The skin may be lightly abraded to ensure good electrode contact.
• Baseline Measurements - The patient's blood pressure, heart rate, and ECG readings will be recorded while at rest.
• Exercise or Medication Administration - Depending on the type of stress test being performed, the patient will either exercise on a treadmill or receive medication to increase the heart rate.
• Monitoring - Throughout the stress test, the patient's blood pressure, heart rate, and ECG will be continuously monitored by healthcare professionals.
• Test Completion - The test will continue until the patient reaches a target heart rate or experiences symptoms that require stopping the test.

FAQs

What not to do before a stress test?

How long does an echocardiogram stress test take?

An echocardiogram test usually takes around 10 to 15 minutes.