A cardiac stress test (or cardiac diagnostic test) is a cardiological test that measures a heart's ability to respond to external stress in a controlled clinical environment. The stress response is induced by exercise or by drug stimulation.
Cardiac stress tests compare the coronary circulation while the patient is at rest with the same patient's circulation during maximum physical exertion, showing any abnormal blood flow to the myocardium (heart muscle tissue). The results can be interpreted as a reflection on the general physical condition of the test patient. This test can be used to diagnose coronary artery disease (also known as ischemic heart disease) and assess patient prognosis after a myocardial infarction (heart attack).
The American Heart Association recommends ECG treadmill testing as the first choice for patients with medium risk of coronary heart disease according to risk factors of smoking, family history of coronary artery stenosis, hypertension, diabetes and high cholesterol. In 2013, in its "Exercise Standards for Testing and Training", the AHA indicated that high frequency QRS analysis during ECG treadmill test have useful test performance for detection of coronary heart disease.
- Perfusion stress test (with 99mTc labelled sestamibi) is appropriate for select patients, especially those with an abnormal resting electrocardiogram.
- Intracoronary ultrasound or angiogram can provide more information at the risk of complications associated with cardiac catheterization.
Stress cardiac imaging is not recommended for asymptomatic, low-risk patients as part of their routine care.
Absolute contraindications to cardiac stress test include:
Acute myocardial infarction within 48 hours
Unstable angina not yet stabilized with medical therapy
Uncontrolled cardiac arrhythmia, which may have significant hemodynamic responses (e.g. ventricular tachycardia)
Severe symptomatic aortic stenosis, aortic dissection, pulmonary embolism, and pericarditis
Multivessel coronary artery diseases that have a high risk of producing an acute myocardial infarction
Decompensated or inadequately controlled congestive heart failure
Uncontrolled hypertension (blood pressure>200/110mm Hg)
Severe pulmonary hypertension
Acute aortic dissection
Acutely ill for any reason
Before your test
For 48 hours prior to your test, stop Viagra, Cialis and Levitra.
On the day of your test
For two hours prior to your test: Do not eat, drink or smoke.
Take your usual medications unless otherwise directed by your physician. Bring all of your medications with you in the original bottles.
Wear comfortable clothes and shoes that are suitable for walking on a treadmill.
After your test
There are no restrictions after the treadmill exercise stress test.
Dr Jagmeet S Soin
MBBS (AIIMS), MD, FACC, FACP, FACNP
US Board Certified
Dr Jagmeet S Soin is an alumini of 1967 batch of All India Institute of Medical Sciences New Delhi, India. Dr Soin has an experience of over 45 years working in some of the top hospitals in USA like The Johns Hopkins Medical Centre and Boston City Hospital (Tufts University ). He is considered to be the pioneer in application of nuclear medicine in cardiac diagnostics. Dr Soin is one of the few internists and nuclear medicine physician in India.
Dr Monil Kadian
MBBS, MD (Medicine), Fellowship In Cardiology From John Hopkins Medical Centre, USA
Dr Monil Kadian is a highly trained cardiologist and heart specialist in Gurgaon, Delhi (NCR) India. Dr Monil has experience in treating various heart related problems like hypertension or blood pressure, chest pain, high cholestrol levels, breathing difficulty, tiredness and dysnea. Dr Kadian has special interest in medical and preventive cardiology.
He has done special training and fellowship in cardiology from John Hopkins Medical Centre USA which is considered as one of the best hospitals for training in cardiology.