Stress Tests

Treadmill Stress Test

The treadmill test evaluates what your heart does during activity and if enough oxygen is getting to your heart muscle during exercise. Heart rate, rhythm and blood pressure are monitored during the entire test. EKG electrodes (sticky pads) are placed on your chest, and a blood pressure cuff is wrapped around one of your arms.

You will be asked to walk on a treadmill. As you do, the speed and slope will increase. You will probably walk less than 15 minutes, but the total length of the test may be longer.

Preparation for a stress test:

• Some of your medications may be restricted before your test.
• Do not eat foods or drink beverages that contain caffeine, even if they say “caffeine-free.” Caffeine is found in chocolate, tea, coffee and soda.
• Your food will be restricted before the test.
• Wear sturdy walking shoes.
• Discuss any concerns with the nurse or doctor performing your test.

During and after the test:

• Let your doctor or nurse know if you are having chest pain, dizziness or other symptoms.
• Once you have finished walking, your EKG and blood pressure will be checked for several more minutes while you are resting.

Pharmacological (Drug) Stress Test

If you and your doctor have decided that you are unable to walk for a regular treadmill test, you will lie on a bed in the stress lab. You will  receive an IV and be given medication. The
medication replaces walking on the treadmill. 

Your heart rate, rhythm and blood pressure will be monitored throughout the test. It is important to let your doctor or nurse know if you are having any symptoms, such as chest pain, dizziness or shortness of breath. 

You may or may not be able to take all of your medications before the test. You also will have caffeine and food restrictions before the test.

Isotope Stress Test

An IV is started in your arm before your treadmill stress test. A chemical called an isotope (radioactive substance) will be put in the IV during the test. The isotope sticks to your blood cells and will help show images of your heart and how much blood gets into your heart muscle.

At the end of your stress test, you will be taken to the Nuclear Medicine department to scan pictures of your heart muscle. You will lie quietly on a stretcher with a camera overhead. You may be scanned twice with this procedure, in the same day or two days in a row. If a shadow is seen on your heart muscle picture, it means no blood went to that part of the muscle. The scan will give your doctor additional information concerning your heart.

You may not be able to take all of your medications before the test. You also will have caffeine and food restrictions before the test.

Dobutamine Stress Echo

This test combines a pharmacological (drug) stress test and an echocardiogram. The medication will cause your heart muscle to pump faster, similar to exercise. If you and your doctor have decided that you are unable to walk for a regular treadmill test, you will lie on a bed in the stress lab. You will receive an IV and be given medication. An echo test is performed before the IV is started, as well as after the medication is given. This will help your doctor see if there are any changes in your heart muscle and if your heart is getting enough oxygen.

You will have some restrictions with medications, food and caffeine before this test.

Transesophageal Echo (TEE)

This test is a more detailed echocardiogram. You will have an IV started and lie in a hospital bed. Your throat is sprayed and will be numb. A mild sedative is given and you may sleep through this test. Your doctor will gently put a small, flexible, lubricated tube into your mouth and down your esophagus (swallowing pipe).

You’ll be able to breathe normally. The end of this tube has a small probe that can provide echo images. The tube can be moved around slightly to see your heart at different angles. You should feel little or no discomfort with this procedure. Your heart rate, blood pressure and breathing will be monitored during this test.

Preparation for a TEE:

• Do not eat or drink after midnight the night before the test.
• You may take your regular medicines with a small amount of water (1/4 cup or less) before the test.
• If you have dentures, they are removed before the test is started. The nurse will help you with them after you are awake.
• You will not be allowed to eat or drink until the medicine used to numb your throat wears off. This usually takes 30 to 60 minutes.
• You may not drive yourself home after your test. Before coming for your test, arrange for someone to take you home afterwards.