A cardiac stress test determines how well your cardiovascular system (your heart and blood vessels) works when you exercise and when you’re at rest.
At Phoenix Heart, we administer three types of stress tests:
Electrocardiogram (EKG) or exercise stress test
Stress echocardiogram
Nuclear stress test
During all three tests, you have electrodes attached to your chest. During the nuclear test, they’re also placed on your legs and arms. And before the nuclear test, a special dye is injected into your arm that helps provide clear pictures of your heart taken before and during the test.
Your physician selects which tests are appropriate for you based on your medical history and symptoms. If an exercise stress test doesn’t provide enough information, your doctor may select the nuclear stress test to help diagnose your symptoms. This test can also determine how well current treatment is working and guide your treatment plan.
Following are five important points to help you understand the purpose of a stress test and what happens during the test.
What a cardiac stress test can reveal
The test can help reveal three important heart conditions by:
Helping determine whether you’re developing coronary artery disease
Tracking whether congestive heart failure is worsening
Showing how well your heart is functioning after a heart attack
Coronary heart disease, especially when untreated, can lead to a heart attack or stroke. The arteries that bring blood to your heart can begin to build up plaque, a substance containing cholesterol. The plaque hardens, narrowing the arteries and restricting blood flow to your heart.
A cardiac stress test can reveal blockages in your arteries through the various types of information it collects. If your blood oxygen level is below normal, the test reveals that your blood flow is partially blocked. If this occurs when you’re at rest or when you just begin to exercise, it’s very likely a significant blockage requiring immediate attention.
If your blood pressure and pulse elevate significantly while you’re exercising, your heart is working overtime because the blood flow is restricted. When you’re at rest, even if your arteries have narrowed, your heart can still get enough blood to function well, whereas when you exercise vigorously, a blockage becomes evident.
Preparation before the test
You walk on a treadmill during the stress test, so wear your athletic shoes and loose, comfortable clothing. You’ll temporarily remove your shirt when the technician places electrodes on your chest.
If you smoke, you need to stop at least 24 hours before the test. Likewise, avoid eating or drinking anything with caffeine 24 hours prior. Remember that some energy bars and chocolate contain caffeine. So do many weight-loss pills as well as pills to keep you awake like No-Doz. Four hours before the test, you must stop eating and drink only water.
Before the day of the test, tell your doctor about any medication, prescription or otherwise, that you take, including supplements so that they can advise you about which ones to stop before the test.
During the test
While you’re on the treadmill, the intensity of your workout increases every few minutes; the technician increases the incline and/or speed. Your breathing may be heavy and you may sweat, but if you start to feel any pain, tell the technician immediately.
You should not continue the test if you feel chest pain or if you get dizzy. Your technician also stops the test if your blood pressure drops or spikes abnormally or if you have an arrhythmia.
After the test
After the test, it’s normal to feel tired and winded. But if you start experiencing any type of symptoms associated with heart disease such as tightness or pain in your chest; pain in your jaw, neck, back, stomach, or arm; cold sweat with dizziness; or trouble breathing, call 911 or have someone take you to the emergency room.
Call or book an appointment online with Phoenix Heart for heart health treatment that’s the gold standard in heart health care.
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Preparations for the Test
- You can print and fill out the Cardiac Imaging Questionnaire, before arriving to speed the registration process.
- Do not eat or drink caffeine products (chocolate, soda, tea, coffee or Excedrin®) for 24 hours before exam. Note: Decaffeinated products contain caffeine.
- Consult your physician about going off beta blockers for 48 hours and calcium channel blockers 24 hours before your exam.
- Do not eat or drink for three hours before your appointment. Drinking water is OK.
- If you are unable to exercise on the treadmill, a medication will be administered to stress your heart. If you are undergoing this type of an exam, you may take all your heart and blood pressure medications as instructed by your physician.
- If you have diabetes, please speak to your physician prior to this exam to receive special instructions you may need regarding your medications.
- For SPECT exams, wear comfortable clothes and rubber-soled shoes or sneakers for the treadmill portion of this exam.
- Please bring all your medications or a list of them with doses to your appointment.
During the Test
- Approximate visit time for SPECT is three to four hours, and for PET it is two to three hours.
- You will receive two injections of a small amount of radioactive material. The level of radioactivity used is extremely low and has no side effects.
- To minimize the number of injections you receive, an intravenous line (IV) will be placed in your arm prior to your first injection (thallium) and will be re-used later for your second injection (Cardiolite).
- Following your first injection, you will be placed under a gamma camera and pictures of your heart will be recorded. This camera does not produce any radiation. It will be placed close to your chest and pictures will be taken for approximately 30 minutes. This portion of the test is called the rest study.
- Following your rest study, our trained staff will place EKG leads on your chest. The EKG will be used to constantly monitor your heart during your stress test.
- Your heart will be stressed, either through exercise or through the use of medication.
- During the test you will be constantly monitored by a Nurse Practitioner or a Physician.
- The actual stress portion of the test takes about 10 to 15 minutes, however the preparation takes longer (up to 30 minutes).
- Before the end of the stress test, a second injection (Cardiolite) will be administered. This radiopharmaceutical is taken up by your heart muscle and can be visualized by the gamma camera in the same manner as the rest study.
- The imaging portion of your stress study will take approximately 45 minutes.
What to Expect
- Normal responses during testing include feeling tired, shortness of breath and sweating.
- You should tell the nurse practitioner or physician if you feel any of these symptoms: chest, arm or jaw discomfort, severe shortness of breath, extreme tiredness, dizziness, lightheadedness, leg cramps or soreness.
- The test will be changed or stopped if it is unsafe for you to continue.
After the Test
- When the test is over, you may eat or drink and return to your normal routine.
- You may resume all your medications.
- Your films will be reviewed by our nuclear cardiologists, and results will be sent to your physician. Your physician will discuss these results with you and explain how the results relate to your health.
- To request a copy of your report, call 310-423-8000.
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