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Exercise Stress Test


A stress test, also called an exercise stress test, is used to gather information about how well your heart works during physical activity. Because exercise makes your heart pump harder and faster than it does during most daily activities, an exercise stress test can reveal problems within your heart that might not be noticeable otherwise.


Your doctor may recommend an exercise stress test if he or she suspects you have coronary artery disease or an irregular heart rhythm (arrhythmia). An exercise stress test may also be used to guide your treatment if you've already been diagnosed with a heart condition.


Why it's done?


Your doctor may recommend an exercise stress test to:


  • Diagnose coronary artery disease. Your coronary arteries are the major blood vessels that supply your heart with blood, oxygen and nutrients. Coronary artery disease is a condition that develops when these arteries become damaged or diseased — usually due to a buildup of deposits containing cholesterol called plaques. If you have symptoms such as shortness of breath or chest pains with exertion, an exercise stress test can help determine if they're related to coronary artery disease.
  • Diagnose heart rhythm problems (arrhythmias). Heart arrhythmias occur when the electrical impulses that coordinate your heart rhythm don't function properly, causing your heart to beat too fast, too slow or irregularly. If you have symptoms such as a racing heartbeat, slow heartbeat or a fluttering in your chest, an exercise stress test can help determine if they're related to an arrhythmia.
  • Guide treatment of heart disorders. If you've already been diagnosed with coronary artery disease, arrhythmia, valvular heart disease or another heart condition, an exercise stress test can help your doctor find out how well treatment is working to relieve your symptoms. It may also be used to help establish the right treatment plan for you by showing how much exercise your heart can handle. 
In some cases, stress tests may be used to help determine the timing of cardiac surgery, such as valve replacement. In some people with heart failure, results from a stress test may help the doctor evaluate the need for heart transplantation or other advanced therapies.


Who shouldn't take a stress test?


  • Some people aren't healthy enough to withstand a stress test. You shouldn't take the test -- or engage in any other vigorous exercise -- if you have recently had a heart attack or if you have high-risk unstable angina; uncontrolled symptomatic heart failure; severe hypertension (systolic pressure over 200 or diastolic pressure over 110); inflammation of the heart (pericarditis, endocarditis, or myocarditis); acute aortic dissection; uncontrolled arrhythmia (unusual rhythms in the heartbeat); or blood clots in the lungs or deep veins. You may also be unable to take the test if you have severe physical disabilities or if you're extremely heavy. (The equipment usually can't support more than 350 pounds.)
  • Some cases call for extra caution. Patients with advanced diabetes, Parkinson's disease, mitral valve prolapse, frequent arrhythmia, thyroid problems, or certain other illnesses may have trouble enduring the test. If you have one of these conditions, your physician will give you a thorough checkup before ordering the test.
  • In addition, many medications can make the stress test hard to interpret. If you're taking digoxin, anti-arrythmia drugs (such as quinidine or procainamide), blood pressure medications, or tricyclic antidepressants, the test may be less accurate than usual.



How to prepare?


You may be asked not to eat, drink or smoke for two hours or more before an exercise stress test. You can take your medications as usual, unless your doctor tells you otherwise.


If you use an inhaler for asthma or other breathing problems, bring it with you to the test. Make sure your doctor and the health care team member monitoring your stress test know that you use an inhaler.


What you can expect?


The test takes place on the treadmill that accelerates its speed and inclination. Your ECG, pressure, heart rate, is monitored constantly. You might be asked to shave part of your chest hair to allow a correct reading of the signals from the electrodes placed on your chest.


The duration of the test is approximately 20 min. After the test you will be asked to take some time to relax. We kindly ask you to bring sport clothing:  shorts, t-shirt, running shoes, as well as a towel if you wish to take a shower in our facility after the test.





If the information gathered during your exercise stress test shows your heart function to be normal, you may not need any further tests.


However, if the results are normal and your symptoms continue or become worse, your doctor may recommend you have a nuclear stress test or another exercise stress test that includes an echocardiogram before and after exercise. These tests are more accurate and provide more information about your heart function, but they are also more expensive.


If the results of your exercise stress test suggest coronary artery disease or reveal an arrhythmia, the information gathered during the test will be used to help your doctor develop a treatment plan. You may need additional tests and evaluations, such as a coronary angiogram, depending on the findings.


If the purpose of your exercise stress test was to guide treatment for a heart condition, your doctor will use data from the test to establish or modify your treatment plan, as needed.





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