What Is a Stress Test, and Why Is It Important?

If you’ve experienced chest pain or palpitations or your primary care physician or cardiologist believes you are at significant risk of arterial blockage, you may be referred for a stress test. Stress testing is a very common, informative, and non-invasive diagnostic procedure to learn more about how your heart is functioning.

The mechanism by which stress testing works is in the name. By putting physical stress on the heart, we can measure how it reacts at rest and after strain is placed on it with exercise. We can also gauge the heart’s reaction after that stressful event. Typically stress tests will involve the patient walking on a treadmill or exercising on a stationary bike for some time to increase their heart rate.

By doing this, we can learn more about:

• Whether there may be blockages known as atherosclerosis
• Potentially diagnose exercise-induced cardiac arrhythmias
• See how you are recovering after a procedure or treatment
• See if you are a good candidate for surgery

What the Results Mean

If a stress test proceeds uneventfully, we can’t necessarily rule out heart disease, but this is generally a good indicator of overall heart health.

At other times, a stress test may show potentially problematic results, which could require some additional testing. Once again, stress testing is not a definitive diagnosis of a heart condition but gives us a quick and painless way to understand if further testing may be necessary.

Further Testing After a Stress Test

By its very nature, stress testing is imprecise in diagnosing a specific condition. Further testing may be necessary, and you may be referred for a nuclear stress test which is very similar but uses radioactive dye or a contrast agent to give us a better look at how blood is moving through the arteries and veins as well as how effectively the heart is pumping that blood. Nuclear stress testing is very safe and has few side effects or risks.

If your stress test indicates a potential blockage, cardiac catheterization may be an appropriate next step. This is an interventional but minimally invasive procedure whereby a catheter is threaded into the blood vessel to check for blockages. If a blockage is found, we can often perform angioplasty with stenting to open the blood vessel and allow for improved blood flow, thus reducing the risk of a heart attack. If plaque in the artery has hardened, an atherectomy or a CABG (bypass) may be necessary to restore blood flow.

Preparing for Your Stress Test

Preparation for your stress test is relatively straightforward, and you will receive guidance from our office to ensure it goes smoothly. How the stress test proceeds are based mainly on what you tell us about your abilities and exercise habits, so be forthcoming. Most importantly, don’t overthink the stress test. It is an essential part of your ongoing cardiovascular care.

During the Stress Test

A nurse or other staff member may administer these stress tests by putting electrodes on your chest and extremities and having you exercise on a treadmill or stationary bicycle. Over the course of the test, you will be asked to perform ever more strenuous activity until your target heart level is reached. Be sure to let the nurse or technician know if you have chest pain, shortness of breath, dizziness, or heart palpitations. Should the test not be completed due to physical concerns, you may be given a drug that mimics the stress test.

As with most diseases, early detection is critically important. Therefore, if you have any unusual pains or sensations that you believe may be from your heart, we encourage you to visit our office as soon as possible. Stress testing, amongst other diagnostic tools, can go a long way to managing cardiovascular risk and maintaining your heart’s health.

Of course, if you have an emergency or think you may be having a heart attack, call 911 immediately.