What is a Stress Test, Heart stress test

What is a stress test?: a test that takes a picture of your heart while its running

When doctors want to study the heart in detail, they often start with a type of test called a “stress test.” Stress tests examine the heart in different ways while the heart is beating. Performing a stress test on the heart is like examining a runner while they are in a race—doctors want to see the heart muscle in action.

A heart stress test gives different types of information about the heart.

They can find blockages in the arteries that send blood to your heart. This known as coronary artery disease.
They can be used to examine tight valves. This helps doctors to decide if valve replacement surgery is necessary.
Stress test overall results are “prognostic.” This means they can help peek into the future and predict your long-term health.

The “stress” in a heart stress test has nothing to do with the emotional stress we all feel from time to time. This type of stress is a medical term used to describe something you put the heart through to see how well it handles it. There are three ways we can stress the heart when we want to test it.

Types of "stress" in stress tests

Exercise

Considered the best and most complete type of stress. This can be done by walking on a treadmill or riding a stationary bike. The exercise starts off slowly and gets harder over time until you cannot do it anymore because you either get tired or develop symptoms. This is the type of "stress" used in a treadmill stress test and stress echocardiogram.

Medication that speeds up your heart

For those who cannot exercise because they have a physical disability, this type of medication makes the heart behave as if it were exercising. The medication’s dose is slowly increased until the heart is beating fast enough to be examined. This type of "stress" can be used in stress echocardiogram and in nuclear stress tests.

Medication that opens up all the blood vessels that give blood to your heart

This is usually given as a single dose or through an infusion that runs for one or two minutes. This type of stress can only be used in nuclear stress tests.

The “test” part of heart stress test is more than just a single test. During the stress test, the heart and your body are monitored and examined in several ways. All stress tests monitor your blood pressure, heart rate and electrocardiogram. This is done for safety, and also because these measurements will provide important information. There may also be a second part to the stress test that takes images of the heart. This can be done with a nuclear camera or an ultrasound.

What are the different types of stress tests available?

How are stress tests done?

The way stress tests are done is by comparing the heart at rest with the heart at stress.

Heart at Rest:

Heart at Stress:

What are the different types of stress tests available?

Your doctor will decide the best way to study your heart. Doctors consider your age, other medical conditions and your chances of having a heart attack when deciding what type of stress test is right for you. For this post, we will cover the types of stress tests that DO NOT use radiation to look at the heart. Because they are different in very specific ways, we will discuss those tests in another tablet. Let’s look at the different types of stress tests available today.

ECG Exercise Stress Test
Also known as a treadmill stress test. This is the simplest type of stress test available. It uses the electrocardiogram and exercise to test the heart. Most stress tests of this type are completed using the Bruce Protocol of exercise on a treadmill, but can also use a stationary bicycle. An ECG stress test takes about 20 minutes to complete.
Exercise Stress Echo
Also known as a stress echocardiogram. The exercise stress echo is very similar to the ECG Exercise Stress Test. It uses the same parts, but adds an echocardiogram either during the exercise if you are using the bicycle, or immediately after if the exercise is done on a treadmill.
Pharmacological Stress Echo
This is another type of stress echocardiogram. This test replaces the exercise with a medication called Dobutamine. Dobutamine is a synthetic form of a substance the body uses to make your heart rate go up. Your electrocardiogram and vital signs are monitored while you get a continuous intravenous dose of this drug. Usually, an echocardiogram is done while you are getting the drug. The drug is stopped once a certain heart rate has been reached.

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Last Modified: Apr 2, 2021 @ 9:12 pm

About the Author

Jose Taveras M.D. F.A.C.C.

Dr Taveras works as a cardiologist caring for spanish speaking communities in the Bronx. He completed a dual residency in Internal Medicine and Pediatrics and then served as chief resident of internal medicine at the St. Vincent’s Catholic Medical Center of New York. He went on to specialize in cardiovascular disease at NYU Winthrop Hospital , under the mentorship of Dr. Kevin Marzo, chief of Cardiology at Winthrop. He is board certified in both internal medicine and cardiovascular diseases, and sub specializes in echocardiography, nuclear cardiology and computed tomography of the heart. Apart from his work in community outreach, Dr. Taveras' career focuses on innovation and technology. Dr. Taveras is a fellow of the American College of Cardiology.