Heart and Vascular Health What to Expect During a Stress Test By Heart and Vascular Institute, April 16, 2016 If you’ve experienced symptoms like chest pain or shortness of breath, your doctor might use a stress test to find out if you have a heart problem. What Is a Stress Test? Stress tests measure how well your heart works during activity, or stress. It is one of the most common tests doctors use to diagnose and monitor many types of heart conditions. Your doctor might order this test to find out: If you have heart disease How well treatment, such medicine, angioplasty, or heart surgery, is working Whether you are healthy enough to start an exercise program or have surgery What to Expect During Your Stress Test Stress tests take place in your doctor’s office or a hospital. During the test, a doctor, nurse, or technician will be with you to keep an eye on your blood pressure and heart rate and to monitor your symptoms. There are different types of stress tests, including: A standard exercise stress test, which uses an electrocardiogram, or EKG, to measure your heart’s electrical signals while you exercise, typically by walking on a treadmill An exercise stress echocardiogram, which includes an echocardiogram, a kind of heart imaging test, to make pictures of your heart before and after either walking on a treadmill or use of a medicine that takes the place of exercise A nuclear stress test, which uses a small amount of radioactive material and a special camera to take pictures of your heart before and after either walking on a treadmill or use of a medicine that takes the place of exercise Your doctor will decide what kind of test is best for you based on your symptoms and general health. Before your test, your doctor will tell you how to get ready, including what to wear and whether you should take your regular medicines. Standard exercise stress test Before the test, a nurse will put sticky patches called “electrodes” on your chest, arms, and legs. The nurse may have to shave your skin to make sure the patches stick. The electrodes will connect to an EKG, which records your heart’s electrical activity. The nurse will place a blood pressure cuff on your arm to measure your blood pressure during the test. During the test, you’ll walk on a treadmill or pedal a stationary bike until your heart is working as hard as it can. The exercises will get more difficult during the test. If you’re not able to exercise, you’ll receive medicine to mimic the effects of exercise. This can cause chest pains, flushing, or other symptoms that go away after the test is done. Be sure to tell the nurse about any symptoms you have, including: Chest pain Shortness of breath Dizziness Exercise stress echocardiogram An exercise stress echocardiogram is similar to a standard exercise stress test, but you have an echocardiogram, or “echo,” before and after you exercise or take medicine to make your heart work harder. An echocardiogram uses sound waves to take moving pictures of your heart. During an echocardiogram, a specially trained technologist presses a small device called a “transducer” against your chest and moves it back and forth. The transducer detects and transmits sound waves, which are then read by the test monitor to show images of your heart. Nuclear stress test A nuclear stress test uses a small amount of radioactive material and a special camera to take pictures of your heart before and after you exercise or take medicine to mimic the effects of exercise. During the test, you get a shot of a harmless radioactive tracer and your heart is scanned as you rest. Next, you will exercise or take medication to make your heart work harder, then get another tracer shot and scan. A traditional nuclear stress test uses a gamma camera, a ring-shaped imaging machine, to take pictures of your heart at rest and after activity. In a gamma camera, you must lie still with your arms over your head, and each scan will take about 20 minutes. Doctors at the UPMC Heart and Vascular Institute also use the newer D-SPECT® nuclear cardiology camera, which allows you to sit up during the scans. This camera is available at UPMC Presbyterian. Getting Stress Test Results Your doctor will usually have the results of your stress test in about a week and will go over the results with you. If your results are normal, you may not need other tests. If your results are abnormal, you may need other tests to find out what is causing your symptoms. For more information about stress testing, contact the UPMC Heart and Vascular Institute at 1-855-UPMC-HVI (876-2484).