Exercise Stress Test

What is an exercise stress test?

An exercise stress test (EST) is designed to assess how your heart responds to increasing workload (exercise). The test also can show if the blood supply is reduced in the arteries that supply the heart. It can help provide information about the level to which you can exercise, if there are any problems affecting your ability to exercise, and how your condition changes with exercise.

There are different reasons why your cardiologist may want you to have an EST and these may include:

  • symptoms or signs suggestive of coronary artery disease (CAD), chest pain, Shortness of Breath
  • significant risk factors for CAD such as smoking, high blood pressure, high cholesterol
  • evaluation of exercise capacity in patients with unexplained shortness of breath or fatigue
  • evaluation of blood pressure response to exercise
  • examination for exercise-induced heart rhythm disturbances (arrhythmias)
  • assessment of your condition after a cardiac procedure such as bypass surgery or coronary angioplasty
  • significant risk factors for CAD such as smoking, high blood pressure, high cholesterol

How do I prepare for the test?

  • Avoid the use of oils, body lotions, moisturizing soaps or body washes for 3 days prior to testing. These products may affect the quality of your EKG tracings. Examples of these are “Oil of Olay” “Dove” “Ivory” “Caress” or “Aveeno”.
  • Tell your doctor if you are allergic to any tape or other adhesives
  • There are no dietary restrictions prior to the test, but you should avoid eating a large meal immediately before your scheduled appointment time since you will be exercising
  • If you smoke cigarettes, it is advisable to avoid smoking immediately prior to your appointment
  • Please come dressed for exercise. It is very important to wear a short-sleeved shirt and sneakers.
  • Please DO NOT wear skirts, dresses, loose pants, slip-on shoes, boots, sandals, or flip flops
  • Please secure long hair
  • Females should wear a bra.
  • For male patients, it will be necessary to shave any area where there is hair in order to get appropriate tracings. If you prefer, you may do this at home within at least 24 hours prior to your test.

Unless otherwise indicated, please take all of your medications prescribed by your provider as directed on the morning of your test,

 

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What can I expect?

  • The test will be supervised by a Hamilton Cardiology Nurse, Nurse Practitioner or Physician Assistant. A Cardiologist is immediately available at all times in case of any medical emergency.
  • Prior to testing, electrodes (sticky gel pads) will be placed on your chest so you can be connected to an EKG machine for monitoring during your test.
  • The EKG patches need to be placed on bare skin. The areas where the patches are placed will require cleansing with an alcohol pad and a light abrasive pad.
  • For male patients, it will be necessary to shave any area where there is hair in order to get appropriate tracings. If you prefer, you may do this at home within at least 24 hours prior to your test. Otherwise, one of our techs will be required to shave the appropriate areas while placing the EKG patches.
  • These electrodes will be attached to cables that link to an ECG machine. This will be looped around your waist with a belt during the test. A blood pressure cuff will be placed around your arm.
  • You will perform a graded EST. This means the work level will be advanced in pre-determined stages in order to increase your heart rate. The treadmill will usually begin at a very slow ‘warm-up’ pace. Every three minutes it will gradually increase in speed and incline (slope).
  • Your pulse, blood pressure, and ECG are monitored during and after the test. If these reach any critical level as determined by the monitoring nurse or physician’s assistant, the test will be stopped immediately.
  • The test will be stopped if you become very tired, short of breath, experience severe chest pain, or reach a maximum predetermined heart rate based on your age.
  • You will be asked at times during the test if you have any symptoms such as chest or leg discomfort or shortness of breath. If you feel unwell you should inform us at once
  • You may request that the test be stopped at any time. However, the higher the level of exercise that you are able to complete, the better the results will be for your cardiologist.
  • The length of time that you will be exercising will usually be three to ten minutes for most patients.
  • The test will be interpreted by one of our Board Certified Cardiologists.
  • Upon review of the results of your stress test, your cardiologist may recommend additional testing. These may include Nuclear Stress Test, Holter Monitor, or Cardiac Catheterization.

What are the risks?

  • In recommending this procedure your doctor has balanced the benefits and risks of the test against the benefits and risks of not proceeding. Your doctor believes there is a benefit of you having an EST.
  • The procedure is generally very safe however a few risks include
    • mild angina e.g. chest pain
    • shortness of breath
    • sore muscles or joint pain
    • fainting (rare)
    • an abnormal heart rhythm that continues for a long time. This may require further treatment to correct (rare)
    • heart attack (extremely rare)
    • death as a result of this procedure is extremely rare, less than 1 in 10,000 patients

The risks are higher if you already have blocked arteries in the heart (Coronary Artery Disease)