This test is noninvasive, generally safe and painless. It may be administered in a number of different settings, including clinics, hospitals or physician’s offices. Exercise stress tests may be performed with echocardiography or nuclear imaging techniques. Another type of stress test uses drugs instead of physical activity to produce the effects of exercise during the examination.
A physician may recommend an exercise stress test for a number of reasons:
- To diagnose conditions such as coronary artery disease (a chronic disease in which there is a “hardening” or atherosclerosis of the arteries) in patients with chest pain.
- To diagnose a heart-related cause of symptoms such as chest pain, shortness of breath or lightheadedness.
- To determine a safe level of exercise among heart patients who wish to increase their level of physical activity.
- To screen for coronary artery disease in some patients who do not have symptoms.
- To gauge exercise capacity in heart failure patients who are being considered for a heart transplant.
- To evaluate the effectiveness of a balloon angioplasty (a procedure in which plaque in the arteries is pushed back against the artery walls to make more room for blood flow), or other procedures.
- To predict future risk of dangerous heart-related conditions, such as heart attack.
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Peripheral Vascular Imaging
Peripheral vascular imaging is ultrasound imaging of the carotid arteries to rule out blockages that can cause strokes.
Transesophageal echocardiography is imaging of the heart from inside the body from the esophagus.
A Holter monitor is a portable electrocardiogram (EKG) that monitors the electrical activity of an ambulatory (freely moving) patient’s heart while the person goes about daily activities. There are a few reasons a physician might request that a patient wear a Holter monitor, but the most common is to diagnose an abnormal heart rhythm (arrhythmia). They are also sometimes used to monitor existing pacemakers, diagnose a lack of oxygen-rich blood flowing to the heart (cardiac ischemia) and measuring variability in the heart rate.
Event monitoring is the use of an EKG monitor that the patient can control to record intermittent arrhythmias.
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A nuclear stress test uses a special radioactive tracer that is injected either during or after the stress test in order to determine which parts of the heart are healthy and receives adequate blood supply and which are not. A nuclear stress test is more accurate than the standard stress EKG test and can provide physicians with additional information.
Congestive Heart Failure
Heart failure (sometimes known as congestive heart failure [CHF]) is a serious condition in which the heart is not pumping efficiently. It is a chronic condition that is the result of other cardiac conditions.
In the late stages of heart failure, the heart is unable to meet the body’s demand for oxygen. In addition, it may cause congestion in the lungs or other problems throughout the body. As a result of the lack of oxygen-rich blood flowing to the body, the heart tries to work harder, which only makes the problem worse.
Conditions that could lead to heart failure include:
- Heart valve disease (e.g., valvular stenosis or valvular regurgitation)
- Infection in the heart valves (valvular endocarditis) or of the heart muscle (myocarditis)
- Congenital heart disease (cardiac conditions present since birth)
- Severe lung disease (e.g., pulmonary hypertension) or obstructive sleep apnea
- Pericardial disease (pericarditis)
- Coronary artery disease
- High blood pressure (hypertension)
- Heart attack
- Diabetes mellitus
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