Cardiac Stress Tests
What is coronary artery disease?
Coronary artery disease (CAD) is a type of heart disease. CAD occurs when the arteries that carry blood to the heart become clogged with fatty deposits (plaque). These buildups can clog the vessels, reducing the amount of blood that flows to your heart. When that happens, more serious problem can develop, including:
- Chest pain, or angina
- Heart attack
- Heart failure
- Changes in your heart rhythm
Coronary vascular disease, including coronary artery disease, was the number-one cause of death in the United States in 2002. Although there is no cure for CAD, there are many treatments available to help you. And there are steps you can take to lower your risk and help improve your blood vessels.
What are the risk factors for coronary artery disease? The more risk factors you have, the greater are your changes of developing heart disease. Common risk factors that doctors look for are:
- Age and gender
- Family history of heart disease
- Diabetes
- High levels of LDL ("bad") cholesterol
- Low levels of HDL ("good") cholesterol
- High blood pressure
- Smoking
- Lack of exercise
- Being overweight
- Poor diet
- Drinking too much alcohol
- Stress
Who's at greater risk for heart disease--men or women?
For many years, heart disease was considered a "man's problem." Since 1984, however, more women than men have died from heart disease. In fact, cardiovascular disease has become the leading cause of death in women in the United States.
Heart disease seems to affect women differently than men. For example, women tend to develop heart disease at later ages than men. The risk seems to increase after menopause. Because women may have less-common symptoms of heart disease, may are not tested for it.
It is important for you to take charge of your health, because coronary heart disease is preventable.
Why does my doctor want me to have this test?
There are several reason you may be asked to have a stress test.
- You doctor may suspect heart disease if you have chest pressure or other symptoms. If you have certain risk factors, such as a family history, he/she may want you to be tested because some people with heart disease feel no symptoms at all.
- If you have already been diagnosed with heart disease, your doctor may ask for a stress test to look for any heart damage you may have, track the progress of your condition and assess your risk for problems in the future, or determine how well your treatment is working.
Where are stress tests given?
The test usually consists of taking pictures of your heart in two phases: a stress phase and a resting phase.
Who performs stress tests?
Stress tests are performed by physicians and nuclear medicine technologists.
How long with the test take?
The stress phase of the test usually take about 3 hours. The resting phase takes less time.
How should I prepare for the test?
Patient preparation instructions in English
Patient preparation instructions in Spanish
What will happen during the stress phase of the test?
To begin, the staff will place a small IV line in your arm. During the test you will be injected with medicine through this IV line. You also will have small pads, known as electrocardiogram or ECG electrodes) attached to your body. The pads will allow the staff to monitor your heart rate.
The stress phase depends on the type of stress used:
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If you are able to walk well, you will exercise on a treadmill. When you reach your peak exercise level, a radioactive medication will be injected into your IV. It will travel through your bloodstream to your heart.
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If you are unable to walk well, you will be given a medication through your IV line that will affect your heart in a way that is similar to exercise. After that, you will be injected with a radioactive medication that will travel through your bloodstream to your heart. You then will be allowed to take a break and return later for pictures to be taken.
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During the last part of the test, you will be lying down on a table while a camera takes images of your heart. The previously injected medication that traveled to your heart, allows the camera to "see" and take pictures of the flow of blood through you heart.
What will happen during the rest phase of the test?
The resting phase of your test, most likely, will occur several days after the stress phase; however, not everyone will require a resting phase. You will report to the Imaging Department and will be injected with a medication that, again, will travel through your bloodstream to your heart. After that, more pictures will show the flow of blood through your heart at rest.
How will I receive my test results?
The doctor will examine your pictures and send a report to your doctor. Your doctor will then discuss the results with you.
How safe is the test?
Some people worry about the exposure to radiation. As mentioned above, one of the medications used is radioactive; however, the amount of radioactivity you will be exposed to is considered safe, according to the National Council on Radiation Protection and Measurements. Tests of this type have been widely used in the United States since the mid-1970s. Today, over 6 million of them are performed in the United States each year.
If you are pregnant, suspect you may be pregnant, or are a nursing mother, discuss this with your doctor before undergoing the procedures.
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