Exercise Stress Test

Anexercise stress test is a cardiac health screening test that allows your cardiologist to assess your heart’s response to exertion and the increased demand for blood that entails. Also known by exercise electrocardiogram (ECG), graded exercise test, or stress ECG, an exercise stress involves jogging on a treadmill or pedalling a stationary bike at increasing levels of difficulty while your heart rate,breathing, and blood pressure are monitored.

An exercise stress test can usually be done at any cardiac health clinic.

Uses of Exercise Stress Tests

An exercise stress test is a heart health screening test can help detect:

  • If there is adequate blood flow to your heart during elevated levels of exertion
  • The effectiveness of heart medications in controllingchest pain (angina) and reduced blood supply to the heart (ischemia/ ischaemic heart disease).
  • Coronary heart disease/Coronary artery disease
  • Identify heart rhythm problems such as an irregular heartbeat (arrhythmia)
  • Safe levels of exercise before you begin an exercise programme 

Your doctor may recommend other cardiac health screening tests with imaging such as a magnetic resonance imaging (MRI) test if a routine exercise stress test fails to pinpoint the cause of your symptoms. 

Types of Exercise Stress Tests

There are several types of exercise stress tests:

  1. Treadmill stress test

Typically the first stress test performed, this involves walking on a treadmill while your heart is monitored.

  1. Adenosine stress test

This test is forpatients who are unable to exercise. Adenosine is a drug that affects the heart as exercise would, and enables your Singapore cardiologist to still determine how the heart responds to stress without the exercise.

  1. Stress echocardiogram

An echocardiogram (or heart ultrasound) is a test that uses sound waves to visualise a graphic outline of the heart’s movement. A stress echocardiogram allows your doctor to see your heart beating and pumping bloodwhen the heart is stressed, and may reveal a lack of blood flow that might not always be apparent on other heart screening tests.

  1. Nuclear stress test

A nuclear stress test helps differentiate the healthy parts of the heart from the parts that are not functioning normally. A small dose of radioactive substance (called a dye) is injected into the patient. Your cardiologist then uses a special camera toidentify the rays emitted from the radioactive substance within the body to visualise the heart tissue on a monitor. By comparing images taken both while at rest and post-exercise, your doctor can identify the areas of the heart that have a decreased blood supply.

Risks

Exercise stress testsare generally safe for adults. However, as with any medical procedure, an exercise stress test does carry a risk of complications.

These include:

  • Low blood pressureduring or immediately after exercise
  • Arrhythmias
  • Heart attack

Serious complications from stress tests such as heart attacks or arrhythmiasare rare.

If you are worried about your suitability for an exercise stress test, consult your cardiologist’s expert opinion.

References:

https://www.nhcs.com.sg/patientcare/ConditionsAndTreatments/Pages/ExerciseTreadmillTest.aspx

https://www.nlm.nih.gov/medlineplus/ency/article/003878.htm

http://www.webmd.com/heart-disease/guide/stress-test