Although a heart attack is sometimes preceded by symptoms such as shortness of breath with exertion or chest pain, a heart attack can also occur without warning. One way in which heart disease can sometimes be detected before it causes serious problems is through use of an exercise stress test. Are you a good candidate for this test?
What is an exercise stress test?
An exercise stress test is a test designed to put your heart under stress through exercise. This occurs in an outpatient setting under controlled circumstances where your heart rate, blood pressure, and breathing rate can be closely monitored. To determine how your heart responds to the stress of exercise, electrodes are attached to your chest so the action of the heart can be recorded. You would then walk on a treadmill to bring your heart rate up while your heart rhythm and patterns are recorded.
How accurate is an exercise stress test?
An exercise stress test can be a good screening tool for heart disease, although it’s not sensitive enough to pick up all cases of coronary artery disease. It can be fairly good at picking up disease of the large vessels of the heart, but not so good at detecting disease in smaller arteries of the heart known as microvascular disease. Even in cases of blockage of the larger arteries of the heart, there usually needs to be significant blockage before the exercise stress test becomes abnormal. This means that coronary artery disease usually needs to be fairly advanced before the test shows abnormalities. There’s also the potential for the test to be positive when heart disease isn’t present, giving rise to a false positive.
If an exercise stress test isn’t all that sensitive, why is it performed?
This test might be a good option for use as a screening tool if you have a high risk of developing coronary artery disease. Although there are more advanced tests to detect heart disease, an exercise stress test is relatively simple, low risk, and low cost. If the test shows abnormalities, your doctor would suggest a more advanced test to look for heart diseases such as a stress echocardiogram or a radionucleotide study.
How risky is an exercise stress test?
Although anytime the heart is diseased and put under stress, there’s the potential for a heart attack to occur, this is very uncommon. The mortality rate from an exercise stress test is less than one in ten thousand. Keep in mind that you’ll be closely monitored during the test and the test will be stopped at the first signs of the problem.
Should you get an exercise stress test?
If you have a strong family history of heart disease in your family or have two or more other risk factors for heart disease, you may want to talk to your doctor about getting a stress test. This is particularly true if you’re planning on starting an exercise program and want to see how your heart will handle the stress of a fitness program. If you already have symptoms that are suspicious for heart diseases such as chest pain or shortness of breath, your doctor may want to schedule you for a more advanced study instead without doing a stress test first. Be sure to let your doctor know about any risk factors for heart disease or symptoms you may be having so you can get the best test for your situation.