Stress Tests
Stress should be a powerful driving force, not an obstacle - Bill Phillips
image by: Niel Romano
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Demystifying the cardiac stress test
Dr. Marc Wallack routinely passed his cardiac exercise stress test with flying colors. He was, after all, a veteran marathon runner with respectable cholesterol and blood pressure numbers.
But as many heart disease patients discover, a treadmill analysis often isn't enough. Six months after a "normal" stress test, surgeons cracked open Wallack's chest for quadruple bypass surgery. An artery was 95% blocked.
"I thought I understood heart disease," said Wallack, a New York City surgical oncologist who has a strong family history of the illness. But his most recent stress test looked fine. So like many men, he convinced himself that the chest pain was merely heartburn.
Cardiac…
Resources
Music Boosts Exercise Time During Cardiac Stress Testing
If you exercise while listening to music, you may have noticed it can help boost your energy and make your workout seem quicker. Similarly, a study being presented at the American College of Cardiology’s 67th Annual Scientific Session suggests listening to music during a standard cardiac stress test can help extend the time someone is able to perform the test, yielding important information about an individual’s heart health and capacity for exercise.
EKGs and exercise stress tests
When you need them—and when you don’t.
Current methods of pharmacologic stress testing and the potential advantages of new agents
This article presents the exciting advances made and ongoing in the area of pharmacologic cardiac stress testing. In particular, new A(2A)-specific receptor agonists work like adenosine but promise the delivery of uncomplicated vasodilator stress testing or the diagnosis and prognosis of coronary disease. These agents, although not perfect, do likely present a level of protection against the complications of bronchospasm and heart block.
Inappropriate Heart Stress Tests May Waste Half A Billion Dollars A Year
The overall growth in these tests was largely explained by changes in the patient population. But the growth in cardiac stress tests with imaging-- far more expensive than a simple treadmill test-- was not explained by these changes. Use of these imaging tests-- most often a nuclear stress test, which involves exposure to radiation-- have exploded in popularity and are far more expensive than the much simpler treadmill test.
Panel Advises Against Routine Treadmill Stress Tests
Every year, hundreds of thousands of older Americans get on a treadmill in a doctor’s office and walk or jog as an electrocardiogram monitors their heart function. But a growing number of medical authorities would like to make routine screening using the procedure, known as the treadmill or exercise stress test, largely a thing of the past.
The Tell-Tale Heart Test: Stress Test vs. CT
CT The worst kind of assurance is false assurance. And that's been one of the problems with conventional cardiac stress tests, including the venerable EKG treadmill test, where you get all wired up and walk for your life.
The Treadmill’s Place in Evaluating Hearts
The treadmill test seeks to answer two questions: “Does the patient have coronary artery disease, and is he or she likely to die or suffer a coronary event soon?” Dr. Miller wrote in the Cleveland Clinic journal. But at best it can provide only an estimate of someone’s risk of having a heart attack or dying of heart disease within a given period of time.
Demystifying the cardiac stress test
Cardiac stress tests, also called exercise or treadmill tests, are commonly used to find evidence of blockages in the arteries of the heart. But they’re not 100% reliable.
Echo Stress Test
An Echo Stress can be obtained in a physician's office or in the hospital. Imaging tests are generally obtained when a physician wishes to confirm or rule out the presence of coronary artery disease. A Stress Echo is also performed in patients who have disease involving the heart muscle or valve, or if a patient is having inappropriate shortness of breath and a cardiac cause is suspected.
Exercise Stress Test
Stress tests are among the best tools for diagnosing heart disease, and some research suggests that they may also be useful in estimating disease risk in people who don't have symptoms but have risk factors such as high cholesterol. If you are over age 40 and are at risk for coronary artery disease because you smoke or have high blood pressure or other risk factors, ask your doctor if you should have this test.
Nuclear Stress Test
During exercise, healthy coronary arteries dilate (develop a more open channel) more than an artery that has a blockage. This unequal dilation causes more blood to be delivered to heart muscle supplied by the normal artery. In contrast, narrowed arteries end up supplying reduced flow to it's area of distribution.
Pharmacologic Stress Test
How does a Chemical Stress Test work? A chemical or pharmacological stress test combines an intravenous medication) with an imaging technique (isotope imaging or echocardiography) to evaluate the LV. In these cases, the medication serves the purpose of increasing the heart load instead of using exercise.
Lexiscan
Lexiscan is the most widely used pharmacologic stress agent.
National Heart, Lung, and Blood Institute
Stress tests pose little risk of serious harm. The chance of these tests causing a heart attack or death is about 1 in 5,000.
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