Key Points

• Stress testing gives your doctor information about how your heart works during physical stress. Some heart problems are easier to diagnose when your heart is working hard and beating fast.
• During a stress test, you exercise (walk or run on a treadmill or pedal a bicycle) to make your heart work hard and beat fast. Tests are done on your heart while you exercise.
• If you're unable to exercise, your doctor may give you medicine to make your heart work hard, as it would during exercise. This is called a pharmacological stress test.
• Doctors usually use stress testing to help diagnose coronary heart disease (CHD), also called coronary artery disease. They also use stress testing to see how severe CHD is in people who have it.
• Some stress tests take pictures of the heart when you exercise and when you’re at rest. These imaging stress tests can show how well blood is flowing in various parts of your heart and/or how well your heart squeezes out blood when it beats. Imaging stress tests tend to be more accurate at detecting CHD than standard (nonimaging) stress tests.
• You may need a stress test if you’ve had chest pains, shortness of breath, or other symptoms of limited blood flow to your heart.
• Standard stress testing often is done in a doctor’s office. Imaging stress testing usually is done at a hospital. Be sure to wear athletic shoes in which you can exercise comfortably. Your doctor may ask you not to eat or drink for a short time before the test. You also may have to adjust how you take certain medicines before the test.
• During all types of stress testing, a technician or nurse will be with you to closely check your health status.
• Standard exercise stress tests use EKGs (electrocardiograms) and breathing and blood pressure monitoring to check blood flow in the heart. Imaging stress tests, such as those that use echocardiography and radioactive dyes, show how well blood is flowing in your heart muscle.
• After stress testing, you’ll be able to return to your normal activities. If you had a test that involved radioactive dye, your doctor may ask you to drink plenty of fluids to flush it out of your body.
• If your test results are normal, no further testing or treatment may be needed unless your CHD symptoms persist. If your test results are abnormal, your doctor may recommend other tests.
• There's little risk of serious harm from any type of stress testing. The chance of these tests causing a heart attack or death is about 1 in 5,000. More common, but less serious side effects may include arrhythmias (abnormal heartbeats), low blood pressure, and jitteriness or discomfort (if you get medicine to make your heart work hard).