Stress Test

Also known as Exercise Stress Test, Treadmill Test
A stress test measures how healthy your heart is and how well it works during physical stress. Some heart problems are easier to identify when your heart is working hard to pump blood throughout your body, such as when you exercise.
Overview

A stress test is used to help diagnose and evaluate heart problems such as ischemic heart disease, heart valve disease, or heart failure. Your doctor may recommend this test if you have symptoms of a heart problem, such as shortness of breath, chest pain, dizziness, and a rapid or irregular heartbeat. If your doctor does find a problem, the stress test also can help your doctor choose the right treatment plan and determine what types of physical activity are safe for you.

A stress test usually involves physical exercise such as walking on a treadmill or riding a stationary bicycle. The test may be done in a hospital or doctor’s office. As you exercise, your doctor will measure your heart rate and blood pressure and your heart’s electrical activity. If you are not able to exercise, your doctor will give you medicine that will make your heart work hard and beat faster, as if you were exercising.

Your doctor will carefully monitor you throughout the test to minimize the risk of complications caused by the exercise or medicine used to raise your heart rate. Intense exercise during the test can cause some heart problems to get worse. If your doctor gives you medicine to make your heart beat harder instead of having you exercise, there is a small risk of developing certain heart problems after the test.

What To Expect - Stress Test

A stress test is usually done in a hospital or doctor’s office. Your doctor will give you instructions to prepare for the test and tell you what to expect during and after the test.

Patient having an exercise stress test.
Stress test. The image shows a patient having an exercise stress test. Electrodes are attached to the patient’s chest and connected to an electrocardiogram (EKG) machine. The EKG records the heart’s electrical activity. A blood pressure cuff records the patient’s blood pressure while he walks on a treadmill.

 

Before the stress test
- Stress Test

Your doctor may ask you not to take some of your prescription medicines or to avoid coffee, tea, or any drinks with caffeine on the day of your test, because these may affect your results. Your doctor will ask you to wear comfortable clothes and shoes for the test.

For the stress test, your doctor will put sticky patches called electrodes on your chest and attach a blood pressure cuff to your arm and a pulse monitor to your finger or other part of your body. Your doctor will measure your heart activity and blood pressure before you start the test.

During the stress test
- Stress Test

You will slowly start to exercise on a treadmill or stationary bicycle, and then gradually increase the treadmill speed or bicycle resistance until your heart is working at the target heart rate for your age. Most often, a stress test includes an electrocardiogram to measure your heart’s electrical activity as you exercise on a treadmill or on a stationary bicycle. Your doctor may also measure your blood oxygen level, blood pressure, and heart rate. During the test, you will exercise for 10 to 15 minutes. Your doctor will stop the test if you show any sign of a heart problem, or if you are too tired to continue the test.

If you are not able to exercise, your doctor will give you medicine over a 10- to 20-minute period through an intravenous (IV) line into one of your blood vessels.

Your doctor may also take images of your heart during or right after the stress test to see how well blood is flowing through your heart and how well your heart pumps blood when it beats. These pictures can be taken by echocardiography or by injecting a radioactive dye into one of your veins, called a nuclear heart scan. The amount of radiation in the dye is considered safe for you and those around you. However, if you are pregnant, you should not have this test because of risks it might pose to your unborn child.

If your doctor also wants to see how well your lungs are working, you may be asked to wear a mask or mouthpiece to measure the gases that you breathe out during the stress test.

After the stress test
- Stress Test

After the stress test, your doctor will measure your heart activity and blood pressure to make sure that both measurements are back within the normal range. You should be able to return to your normal activities right away. 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 stress test shows that your heart is healthy, you may not need further testing or treatment. Your doctor may order other diagnostic tests or imaging tests if the stress test results suggest that you may have a heart condition, if you are physically unable to exercise, or if you continue having symptoms, such as shortness of breath or chest pain.

Research for Your Health

The NHLBI is part of the U.S. Department of Health and Human Services’ National Institutes of Health (NIH)—the Nation’s biomedical research agency that makes important scientific discovery to improve health and save lives. We are committed to advancing science and translating discoveries into clinical practice to promote the prevention and treatment of heart, lung, blood, and sleep disorders, including the use of stress tests. Learn about current and future NHLBI efforts to improve health through research and scientific discovery.

Improving health with current research
- Stress Test

Learn about the following ways the NHLBI continues to translate current research into improved health for people who need stress tests. Research on this topic is part of the NHLBI’s broader commitment to advancing heart and vascular disease scientific discovery.

  • NHLBI-funded research helps establish clinical guidelines for stress testing. The NHLBI-funded PROspective Multicenter Imaging Study for Evaluation of Chest Pain (PROMISE) compared stress testing and computed tomographic angiography to detect a type of ischemic heart disease. Results from this trial showed that both methods are equally effective in diagnosing ischemic heart disease. These findings have helped increase the number of diagnostic tools available to doctors.
  • Study helps improve use of stress testing in women. Diagnosing ischemic heart disease in women can be challenging, partly because diagnostic tests such as stress testing usually have a higher false positive rate in women than in men. NHLBI’s Women’s Ischemia Syndrome Evaluation (WISE) study advanced the understanding of ischemic heart disease in women. Results of this study have helped improve the use of stress tests in the diagnosis and treatment of heart disease in women.

Advancing research for improved health
- Stress Test

In support of our mission, we are committed to advancing research on stress tests in part through the following ways.

Learn about exciting research areas the NHLBI is exploring about stress tests.

Participate in NHLBI Clinical Trials

We lead or sponsor many studies on stress testing. See if you or someone you know is eligible to participate in our clinical trials.

Trials at the NIH Clinical Center

Studying vitamin B3 and its role in improving heart function for people who have heart failure

This study is testing whether a form of vitamin B3 called nicotinamide riboside can improve heart and muscle function in people who have heart failure. Investigators will measure heart and muscle function with several methods, including stress tests. To participate in this study, you must be 18 to 70 years old and diagnosed with heart failure. The study is taking place in Bethesda, Maryland.

To learn more about clinical trials at the NIH Clinical Center or to talk to someone about a study that might fit your needs, call the Office of Patient Recruitment 800-411-1222.

Was your child born with tetralogy of Fallot (TOF)?

This study is investigating whether pulmonary valve replacement surgery can improve quality of life in teens and young adults who were born with TOF. Investigators will determine whether this surgery improves heart function and prevents complications from TOF by several methods, including stress tests. Participants in this study must be 13 to 21 years old and diagnosed with TOF. The study is taking place in Philadelphia, Pennsylvania.

Do you want to help improve heart imaging techniques?

This study aims to improve magnetic resonance imaging (MRI) methods to detect ischemic heart disease. Healthy people and people who have ischemic heart disease will have MRI scans while resting and during a stress test. To participate in this study, you must be at least 18 years old and either healthy or diagnosed with ischemic heart disease. The study is taking place in Los Angeles, California.

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