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Exercise or medication? Do you know what methods there are for cardiac stress testing?
The cardiac stress test is a cardiology examination designed to evaluate the response of the cardiovascular system to external stress in a controlled clinical setting. This stress response can be triggered by physical activity (usually on a treadmill) or intravenous medication that increases the heart rate. As the heart gradually works harder, medical staff will monitor the heart's electrical rhythm and broader electrophysiology with an electrocardiogram (ECG). Clinical staff also monitor pulse rate, blood pressure and symptoms such as chest discomfort or fatigue.
Abnormal blood pressure, heart rate, electrocardiogram, or worsening physical symptoms may indicate coronary artery disease.
Cardiac stress tests do not accurately diagnose all cases of coronary artery disease and often show results in people who do not have the disease. Additionally, this test can detect abnormalities in the heart, such as arrhythmias and conditions that affect electrical conduction within the heart, such as various types of bundle branch blocks.
Stress testing and echocardiography
Stress testing is sometimes performed along with an echocardiogram. This ultrasonography is performed before and after exercise to compare structural differences. Before performing the stress test, an ultrasound image of the resting heart is obtained. Ultrasounds of the "stressed" heart are taken after stress induced by exercise or drugs (usually dopamine). A comparison between the two is used to detect blockage in coronary artery disease.
Cardiopulmonary exercise stress test
The cardiopulmonary exercise stress test is a test that simultaneously measures respiratory gases (eg, oxygen saturation, maximum oxygen consumption). This test is often used to assess shortness of breath, preparation for heart transplantation, and prognosis and risk assessment in patients with heart failure. This test is also commonly used in sports science to measure an athlete's maximum oxygen consumption (V̇O2 max).
In 2016, the American Heart Association issued an official scientific statement advocating cardiorespiratory fitness (quantifiable as V̇O2 max) as a clinical vital sign that should be assessed regularly.
Stress testing using injected core tags
Nuclear stress tests use gamma cameras to image radioactive isotopes injected into the bloodstream. The best-known example is myocardial perfusion imaging. Typically, a radioactive tracer (Tc-99 or sulfur-210) may be injected during the test. After an appropriate waiting time to ensure proper distribution of the tracer, a scan is obtained and an image of the blood flow is captured with a gamma camera. By visualizing the relative amounts of radioactive isotopes in the heart muscle, nuclear stress testing more accurately identifies areas of reduced local blood flow.
Recommended uses for this program
The American Heart Association recommends ECG treadmill testing for patients at intermediate risk for coronary heart disease. In 2013, the AHA stated in its "Exercise Standards for Testing and Training" that the performance of high-frequency QRS analysis in ECG treadmill testing can help detect coronary heart disease. For some patients, 99mTc-labeled perfusion stress testing may also be appropriate, especially those with abnormal resting ECGs.
Common methods of cardiac stress testing are recommended by the American Heart Association and the American Heart Association and offer a variety of ways to assess heart health.
However, a cardiac stress test is an initial assessment of heart problems and should not be considered a solution to all problems. According to the Centers for Disease Control and Prevention (CDC), a common first symptom of coronary artery disease is a heart attack, and cardiac stress testing may have limited predictive power for future heart attacks in many subjects.
Contraindications and Termination Conditions
Cardiac stress imaging is not recommended for routine testing in asymptomatic and low-risk patients. Many medical organizations do not recommend this test unless there are signs of high risk. Absolute contraindications to cardiac stress testing include conditions such as acute myocardial infarction, unstable angina, and severe complications.
Adverse reactions
Side effects of a cardiac stress test include heart palpitations, chest pain, myocardial infarction, shortness of breath, headache, nausea, or fatigue. The radioactive tracers used pose a slight cancer risk because they are chemically carcinogenic. Continued use results in a small risk of cancer.
Drugs promote heart stress
Drug stress testing relies on coronary artery interception. Medications such as adenosine or dobutol can be used to put pressure on the heart when a patient is unable to perform at an adequate level through exercise, and is often chosen for patients with special conditions. Medication selection during this process needs to take into account possible drug interactions and comorbid conditions.
History
Cardiac stress testing has been used since the 1960s as part of diagnostic and prognostic assessment. Over time, as factors affecting the risk of death have changed, the use of cardiac stress testing has evolved.
As with any medical diagnostic procedure, the data obtained from a stress test is only an instantaneous result. Would you consider incorporating these tests into your regular health checkups to prevent potential heart problems?
