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Heart Health Diagnosis: Why is Stress Testing Crucial for You?
A cardiac stress test is an important examination designed to evaluate how the cardiovascular system responds to external stressors in a controlled environment. This response is usually triggered by physical activity (such as running on a treadmill) or by intravenous medication that stimulates the heart rate. As the heart is forced to work harder, the medical team monitors its electrical rhythm and other physiological parameters through an electrocardiogram (ECG), while also observing pulse, blood pressure and whether the patient has symptoms such as chest pain or fatigue. These changes can help diagnose the presence of coronary artery disease (CAD).
“Stress tests cannot accurately diagnose all cases of coronary artery disease and may sometimes indicate a patient may have the disease even if they do not actually have it.”
The main purpose of a stress test is to identify possible heart abnormalities, such as arrhythmias and conditions that affect electrical conduction within the heart. While a stress test can help detect heart problems, a normal stress test is no guarantee that you won't have a heart attack in the future. This is because stress tests ideally only detect arteries that are severely narrowed (about 70% or more).
Stress Test and Echocardiogram
A stress test may be done along with an echocardiogram. This test is done before and after exercise to compare the structural differences in the heart. Resting echocardiograms were obtained before stress application, and stress echocardiograms were subsequently obtained after the specified heart rate was reached. The two sets of images will be compared to check for abnormalities in the movement of the heart, further helping to diagnose the presence of obstructive coronary artery disease.
Cardiopulmonary Exercise Stress Test
In addition, cardiopulmonary exercise stress testing is also widely used to evaluate patients' respiratory gases (e.g., oxygen concentration, maximum oxygen consumption) during exercise. This is important for the assessment of transient dyspnea, preparation for heart transplantation, and prognostic risk assessment in patients with heart failure. The American Heart Association issued an official scientific statement in 2016 supporting the routine assessment of oxygen uptake (V̇O2 max) as a clinical vital sign.
"Cardiopulmonary exercise stress testing can help doctors better understand their patients' exercise tolerance and adjust treatment plans."
Nuclear stress testing
Alternatively, a nuclear stress test uses a gamma camera to take pictures of a radioactive marker injected into the blood. Common examples include myocardial perfusion imaging. In the test, after a dose of the marker is injected and an appropriate waiting time is elapsed to ensure that the marker is evenly distributed, a gamma camera is used to obtain images of blood flow through the heart. The advantage of this test is that it can accurately show the blood flow in different areas of the heart.
Recommended use of stress testing
The American Heart Association recommends an electrocardiogram (EKG) treadmill test as the first test for patients at moderate risk for coronary artery disease. Myocardial perfusion stress testing may also be appropriate in patients with an abnormal resting ECG. Although these testing methods are widely used in clinical practice, the sensitivity and specificity of different tests vary, and doctors will decide which test to use based on the patient's specific circumstances.
Risks and taboos of stress testing
While the benefits of stress testing are significant, there are risks, particularly for patients who are asymptomatic and at low risk. Some studies suggest that the benefit of this test is limited in this group of patients and that it is not recommended for routine use. Absolute contraindications include recent myocardial infarction, urgent angina, unstable cerebrovascular status, etc. Testing should also be terminated immediately if an unexpected medical situation occurs.
"No matter what kind of stress test is performed, patients should promptly inform medical staff if they experience any discomfort during the test."
Whether used to diagnose or prevent heart disease, stress testing has become an integral part of modern cardiology. As medical technology advances, our understanding of these types of tests will continue to grow. Are you ready to take care of your heart health?
