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 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 andand 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.
Before the stress test
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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
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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
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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
Improving health with current research
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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
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In support of our mission, we are committed to advancing research on stress tests in part through the following ways.
- We perform research. Our Division of Intramural Research, which includes investigators from the Cardiovascular Branch and its Advanced Cardiovascular Imaging and Echocardiography Laboratories, performs research involving stress tests.
- We fund research. The research we fund today will help improve our future health. Our Division of Cardiovascular Sciences, which includes the Adult and Pediatric Cardiac Research Program, oversees much of the stress testing research we fund. This research helps us improve the use of stress tests in the diagnosis of heart conditions. Search the NIH RePORTer to learn about research the NHLBI is funding on stress tests.
- We stimulate high-impact research. The NHLBI Strategic Vision highlights ways we may support research over the next decade.
Learn about exciting research areas the NHLBI is exploring about stress tests.
- Finding better physical activity programs for children who have sickle cell disease. NHLBI-funded research uses stress tests to help determine safe physical activity guidelines for children who have sickle cell disease.
- Improving cardiac rehabilitation for people who have heart failure. Cardiac rehabilitation helps people who have heart disease improve their health by adopting heart-healthy lifestyle changes, such as healthy eating patterns and physical activity. However, physical activity can be difficult for people who have heart failure because of a condition known as exercise intolerance. When people have this condition, they are not able to exercise as much as expected for their health and fitness level. The NHLBI supports research using stress tests to better understand exercise intolerance. The research may help improve exercise programs for people recovering from heart failure. Other research supported by the NHLBI uses stress tests as part of its goal to measure and increase the use of cardiac and pulmonary rehabilitation in community settings.
- Using stress tests to help determine which surgeries to use to repair heart defects. People who have a congenital heart defect often have surgery early in life to repair the problem with their heart. NHLBI-funded research uses stress tests to help see which repair surgeries people should have and at what age. Results from these studies may improve medical care for people who have congenital heart defects.
- Using stress tests to better understand chronic fatigue syndrome. People who have chronic fatigue syndrome experience extreme tiredness that does not improve with rest. The NHLBI supports research that is using stress tests to better understand this condition
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.
Was your child born with tetralogy of Fallot (TOF)?
[At NIH Clinical Center] Studying vitamin B3 and its role in improving heart function for people who have heart failure
Do you want to help improve heart imaging techniques?
After reading our Stress Test Health Topic, you may be interested in additional information found in the following resources.