EXERCISE STRESS TEST
An Exercise Stress Test is used as a means of assessing how your heart and blood vessels respond to physical exertion. An ECG is recorded at rest, and then whilst walking on a treadmill, or pedalling on an exercise bike. Throughout the test a Cardiac Technician and a Medical Practitioner will supervise you and look for indications that your heart is not getting enough oxygen, signalling obstructed coronary arteries. Your ECG, heart rate, blood pressure and symptoms will be monitored, and you will be asked about any symptoms such as shortness of breath, chest pain or dizziness. The test takes about 30 minutes to complete.
Why has your doctor ordered a Stress Test?
Your doctor may order a Stress Test to:
1. Determine whether it is likely that you have heart disease. There are many presentations where you may have underlying coronary artery disease
- Symptoms of heart disease such as chest, jaw or arm pain.
- Shortness of breath, chest tightness or discomfort on exertion
- Reduced exercise tolerance
2. To estimate the likelihood of coronary artery disease in asymptomatic people with a high risk factor profile for ischaemic heart disease
- Family history of heart disease – heart attack, angina or documented coronary artery disease in a first degree relative under the age of 60
- Smoker
- Elevated blood pressure
- Elevated cholesterol
- Diabetic
2. To measure exercise capacity in people with known coronary artery disease. An exercise test is used to estimate the severity of the blockages and response of the heart to physical exertion in patients:
- After a heart attack before release from hospital (not in all cases)
- After an angiogram demonstrating blocked coronary arteries
- After angioplasty or stent insertion
- After modification of medications
- After Coronary Artery Bypass surgery
3. To assess the exercise capacity and progression of the disease in people with other cardiac abnormalities, such as:
- Valvular disease
- Cardiomyopathy
4. Routine health screening or assessment prior to commencement of an exercise programme. The value of this type of screening in a person with none of the above symptoms, risk factors or disease processes is of limited value, but can yield some useful information.
Before the Test
- Do not stop taking any medications prior to the test unless you have been advised to do so by your doctor.
On the Day of the Test
- Bring your referral
- Bring a list of your current medications
- Wear a 2 piece out fit and comfortable footware
- Do not wear talc or neck chains
- Have light meals only prior to your test
- Do not have any caffine or nicotine 2 hours prior to the test
Immediately before starting the Test
- You will need to undress to the waist
- Men may require part of the chest to be shaved
- Electrodes will be placed on to the chest and an ECG lead connected, attached to a belt worn around your waist
- A gown is worn over this
During the Test
- You will be supervised by an experienced Doctor and Cardiac Technician
- Your blood pressure, pulse rate and electrocardiogram will be monitored continuously
- The test will be continued as long as the Doctor feels it is appropriate
After the Test
- You will receive some feedback about your performance from the supervising Doctor
- In this time water and a towel will be made available
- You will be asked to rest for about 10 minutes before leaving the premises
- A full report will be sent to your Doctor after the results have been reviewed by a Cardiologist
Will I be able to cope with the treadmill?
The treadmill begins at a very low speed that is increased every few minutes. It is surprisingly easy to walk on a treadmill and can be easily accomplished by most patients, even in their eighties. If you are believe that you would not be able to cope with a treadmill, and that an exercise bike would be more appropriate (or vice versa), then please inform our staff at the time of booking the test.
Is the test dangerous?
The risk of stress tests is low, but rarely patients with heart disease can suffer a heart attack.
For how long will I need to exercise?
You will be encouraged to exercise to exceed a target heart rate that is determined by your age. This may take anything from 2 to 12 minutes. If any of the parameters being measured are of concern to the supervising Doctor, or if you are uncomfortable and not able to proceed further, then the test will be stopped.
How accurate is the test?
The test is accurate in over 90% of cases where there is an abnormal result. Occasionally an abnormal test result is a ‘false positive' suggesting you have coronary artery disease when really you do not.
What does it means to ‘pass'?
If you complete your test without symptoms and without any abnormalities in your ECG, heart rate and blood pressure then your risk of having significant underlying coronary artery disease is low. However coronary artery disease has not been 100% excluded, so you should always discuss any symptoms that concern you with your Doctor.
What does it mean not to ‘pass'?
On the other hand, in some cases if your resting or exercising ECG is abnormal, you develop symptoms, or demonstrate other abnormal measurements during the procedure, then you may have an increased likelihood of significant underlying coronary artery disease. You will be advised to consult with your referring Doctor to discuss the findings further.
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