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Tests for Heart & Vascular Disease

Exercise Stress Test

A test used to assess the effect of stress (exercise) on the heart. The patient is exercised (usually on a treadmill) to increase the heart rate while the EKG, blood pressure and symptomatic response are monitored to detect heart problems. Specialized tests include:

Myocardial Perfusion

A diagnostic test using radioactive tracers to visualize the flow of blood to the heart muscle and aid in diagnosing narrowed or blocked vessels. This test is done in addition to the exercise stress test.

This imaging exam involves three steps:

  1. Blood flow is tested while the heart is at rest.
    An intravenous line (IV) is placed in the patient’s arm and a small amount of the radioactive tracer is injected. After a waiting period, the patient then lies flat on a bed and a gamma camera is positioned over the chest. The camera measures the radioactive gamma rays coming from the heart muscle.
  2. The heart is put under stress.
    To find out if the heart’s blood vessels are becoming blocked, a stress test is performed to dilate the vessels. If vessels are narrowed or blocked they do not dilate adequately, causing a restriction. This restriction limits the flow of blood to an area of the heart. Either an exercise treadmill or a drug called adenosine can be used to increase heart rate. At this point, a second radioactive tracer is injected into the patient’s IV.
  3. Blood flow is tested while the heart is under stress.
    Now the gamma camera takes a second set of images. They are compared to resting images to see how well blood flow is getting to the heart muscle.

 

Why do myocardial perfusion imaging?

  • To investigate chest pain
  • To investigate arrhythmia
  • To assess the amount of heart muscle damage from a recent heart attack
  • To assess how well the heart is working before a major surgical procedure

Is it safe?
The stress portion of the test has some risks.

What are the benefits?
Myocardial perfusion imaging is a nonsurgical, low-risk test that can provide lots of information about artery blockages in the heart. By placing a patient’s heart under physical stress, a disease hidden during the resting state may be uncovered.

How soon will I know the test results?
A physician will interpret the results on the day of your test, and the results will be sent to your doctor. Your doctor will discuss the results with you at a later time.

Print a Quick Reference to Myocardial Perfusion (pdf)

Cardiopulmonary Exercise Stress Test

An exercise stress test used to assess the lungs and heart at the same time. This test can be very useful in helping a doctor make a specific diagnosis between the extent of problems that may be originating from either source.

What is a clinical stress test?
A clinical stress test is the assessment of a patient’s ability to tolerate increasing intensities of exercise while an electrocardiogram (EKG), blood pressure and symptomatic responses are monitored. Ultrasound images or myocardial perfusion imaging can also be used in order to increase the sensitivity of the stress test.

How does a stress test work?
While monitoring the EKG, blood pressure and symptomatic responses, the patient is subjected to physical stress. Typically this is in the form of standard, graded exercise on a treadmill. For patients unable to exercise, a medicine can be given that increases the heart rate and substitutes for physical exercise. During this period of physical stress, heart problems can often be detected.

Why take an exercise stress test?
A stress test can provide valuable information about several medical conditions, including:

  • Coronary artery disease. If the heart muscle isn’t getting enough oxygen, it is usually because of a critical blockage in one or more heart arteries. Oxygen demands created by the blockage may not be noticeable except during physical exertion.
  • Electrical abnormalities. Heart rhythms that are too fast, too slow or irregular may be identifiable during a stress test.
  • Peripheral vascular disease. An exercise test is often used to find out if there is adequate blood flow to the legs.
  • Other exercise-related abnormalities. An exercise test can provide information about pulmonary disease and certain metabolic disorders.
  • Functional capacities. A person’s fitness level or ability to do work can be revealed in an exercise test. This information can help a doctor trying to understand a medical problem.

Is it safe?
Complications associated with exercise testing are relatively rare. Knowing when not to perform the test and when to stop a test keep the incidence of complications to less than 1 percent.

What are the benefits?
Stress testing is a non-invasive, low-risk test that can provide lots of information about various disease processes. By placing a patient under physical stress, a disease that may be hidden while the heart is at rest can often be uncovered.

How soon will I know the test results?
Your doctor will be contacted immediately if serious abnormalities are found. Usually doctor and patient discuss the results at a later date.

Print a Quick Reference to Cardiopulmonary Exercise Stress Test (pdf). 

Exercise Stress Test

Myocardial Perfusion Test

 
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