Cardiac Stress Test: Stress Testing for the Heart
A cardiac stress test is used to identify any blockages in a patient's coronary arteries.
But sometimes it can be difficult to identify the symptoms of coronary heart disease when at rest!
So it is necessary to put the heart under stress and see how it works.
This is what a cardiac stress test does.
A stress test looks at the way the body, and the heart specifically, responds to stress/exercise. This is done in a controlled clinical environment to minimize the risk to the patient.
What is a cardiac stress test
There are a variety of stress tests that a patient can have done. Each of them gives the doctor a little more information so that they can set up a more relevant treatment plan for the patient.
It is important to note that the different stress tests also vary in accuracy with the most accurate of the heart stress tests being the nuclear stress test.
The stress test is done to look at the blood flow to and from the heart. The way the chambers in the heart are working and the valves, a regular heart stress test is going to look at the heart's electrical current, in other words the beat and rhythm of the heart.
Typically a cardiac stress test is ordered when there are symptoms of coronary artery disease or significant risk factors that predispose the individual to artery disease.
Similarly the test administrator may order a regular heart stress test if there is unexplained breathlessness or a need to know the blood pressure response to exercise for people with borderline hypertension.
How is the regular cardiac stress test conducted?
The regular exercise stress test involves the walking on a treadmill or riding a stationary bike.
The patient will come into the exam room and be asked to change from the waist up into a gown, and they will get hooked up to an EKG machine which will monitor their heart rate and beat throughout the test.
Blood pressure will also be monitored repeatedly during the stress test.
The patient will begin by walking on the treadmill and the technician will slowly increase the speed and the incline of the treadmill based on the protocol they are using.
The goal is to get the patient to reach their target heart rate. The target heart rate is typically 85% of the patient's maximum heart rate.
The length of the test will vary depending on the physical fitness level of the patient.
Should the patient develop chest pain, shortness of breath, abnormally low or high blood pressure or dizziness the test is stopped.
An alternative test if the patient is unable to walk on a treadmill or ride a stationary bike is a chemical stress test such as the adenosine stress test.
Is the stress test an accurate measure of stress?
First it is important to understand that a stress test does not measure stress. What they measure is the heart's ability to handle being stressed. What the physician is looking for is any coronary artery disease or any ischemia (a restriction of blood flow.)
A regular stress test is an accurate measure of the way the heart handles load. The level of accuracy varies depending on the type of stress test that is being performed and the extent of the coronary artery disease.
The accuracy of a regular stress test is about 67%. This means that it is able to predict about two thirds of patients with coronary heart disease.
This accuracy of prediction is lower for patients with narrowing in a single coronary artery (roughly 50%) and higher for narrowing in all three major arteries (roughly 80%).
When you do a regular stress test you can usually expect the preliminary results before you leave the cardiologist's office yet the official result will usually take a couple of days.
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