October 01, 2017

Stress test for heart disease

Q: I have a treadmill stress test scheduled to look for heart disease. I know this involves exercising, and I’m worried I’m not physically up to it. Is there another way to gather this information?

A: Yes. There's another way to conduct a heart stress test that doesn't involve exercise. Several drugs can be safely used to mimic the effects of exercise or stress on the heart. This is known as a pharmacological stress imaging study.

However, pharmacological stress testing usually is used only when an exercise stress test can't be performed due to exercise-limiting problems such as musculoskeletal problems, nerve problems or poor lung function.

If you can walk for more than five minutes on flat ground or up one to two flights of stairs without needing to stop, you can most likely exercise enough to complete a treadmill stress test.

An exercise stress test is preferable to one using drugs. Compared with a pharmacological stress imaging study, an exercise stress test:

Provides different information with which to assess the condition of your heart and cardiovascular system. In addition, it provides doctors with information on your exercise heart rate, rhythm or any abnormalities — as measured by an electrocardiogram (ECG).

It also allows doctors to see if exercise reproduces any heart or lung symptoms and how exercise affects other aspects of your cardiovascular system, such as blood pressure and blood flow.

The stress test also measures your ability to exercise at varying levels. It's predictive of cardiac outcomes, and exercise duration is strongly associated with the risk of coronary events and even death.

Often doesn't require any imaging — such as a cardiac nuclear scan or echocardiogram — to be done in conjunction with the test, since the ECG tracings are...