Friday, July 20 , 2018, 4:22 pm | Fair 74º

 
 
 
Your Health
A Noozhawk partnership with Cottage Health

What You Need to Know About a Heart Stress Test

(Cottage Health illustration)

There’s nothing like a good workout to find out how fit you really are. You may feel like a champion in your armchair fantasies, but playing a set of tennis can tell a different story.

Likewise, you don’t know how well your heart is working until you put it to the test. Almost everybody’s heart beats in the same monotonous rhythm when they’re resting. But during exercise, sick hearts and healthy hearts act very differently.

If you’re at risk for heart trouble, your doctor may want to check your heart by monitoring it while you exercise. This type of exam is called a stress test or an exercise tolerance test.

Your doctor will have you walk on a treadmill or ride an exercise bike for about 10 to 20 minutes. The workout will start at a slow pace and gradually grow more intense. By the end of it, you’ll feel like you’re walking or riding a bike up a small hill.

During the test, electrodes on your chest that are hooked up to an electrocardiograph (ECG or EKG) machine will measure the flow of electricity in your heart. You’ll also have a blood pressure cuff on your arm.

Often, a stress test is done in conjunction with other diagnostic tests, such as an echocardiogram, which uses sound waves to create a moving picture of the heart, or a nuclear stress test, which uses a harmless, radioactive substance called thallium to show how well blood flows to the heart.

What Can a Stress Test Reveal?

First and foremost, a stress test can measure how much strain your heart can take.

If the arteries to your heart are clogged with fatty plaque — a condition called coronary heart disease — your heart will struggle to keep up during your workout. Your blood pressure may drop, and your ECG will probably show irregular patterns. You may also feel extremely tired and short of breath.

While the stress test correctly identifies roughly 75 percent of all people with coronary heart disease, people in the early stages usually sail through the exam without a hint of trouble. In general, the test works if the arteries are already more than halfway clogged.

So if the stress test shows that your arteries are blocked, watch out: Unless you and your doctor take action, it’s likely that a heart attack is on the way.

Newer research has demonstrated that stress tests can also aid doctors in determining the likelihood of coronary heart disease even for those without signs of it. In 2005, doctors from Johns Hopkins University reported in a study, published in the journal Circulation, that 90 percent of those who died from coronary heart disease and had no early signs of the illness, scored below average 10 to 20 years earlier on stress tests.

The research team’s analysis showed that study participants who scored below average were two to four times more likely to die from coronary heart disease. More than 6,000 men and women participated in the study from 1972 to 1995.

Doctors may also prescribe light exercise tests if someone has already had a heart attack or has been diagnosed with heart disease. The exercise is often done in a supervised medical setting, and the results can help doctors devise a safe exercise program.

The test may also be used to tell whether a patient is responding to treatment, or how well a pacemaker is working.

Who Needs a Stress Test?

If you’ve already had a heart attack, a stress test can be important to your recovery strategy. Ideally, however, most people would have a stress test BEFORE they ever had a heart attack. With this in mind, the American College of Cardiology recommends the test for the following groups:

» Men over 45 and women over 55, and people with diabetes, who are about to start vigorous exercise programs, especially if they’ve been inactive

» Men over 45 and women over 55 who are involved in occupations in which impairment might affect public safety, or who are at increased risk of coronary artery disease due to other diseases (e.g. chronic renal failure)

» People with several risk factors for heart disease, including smoking, obesity, high blood pressure, diabetes, high cholesterol levels, advanced age, male gender and a family history of heart trouble

» Anyone who has symptoms of coronary artery disease, especially chest pain (angina pectoris)

Is the Stress Test Safe?

The procedure is quite safe. Your doctor will watch you very closely during the test. If you get extremely tired or show any other signs of coronary artery disease, the physician will stop the exam immediately. As a further safeguard, a person trained in cardiac life support will be in the room at all times.

It’s not entirely risk-free, however: About one patient in every 2,500 has a heart attack during the test. But with the proper screening beforehand, there should be little chance of a problem.

Who Shouldn’t Take a Stress Test?

Some people aren’t healthy enough to withstand a stress test. You shouldn’t take the test — or engage in any other vigorous exercise — if you have recently had a heart attack or if you have high-risk unstable angina; uncontrolled symptomatic heart failure; severe hypertension (systolic pressure over 200 or diastolic pressure over 110); inflammation of the heart (pericarditis, endocarditis or myocarditis); acute aortic dissection; uncontrolled arrhythmia (unusual rhythms in the heartbeat); or blood clots in the lungs or deep veins.

You may also be unable to take the test if you have severe physical disabilities or if you’re extremely heavy. (The equipment usually can’t support more than 350 pounds.)

Some cases call for extra caution. Patients with advanced diabetes, Parkinson’s disease, mitral valve prolapse, frequent arrhythmia, thyroid problems or certain other illnesses may have trouble enduring the test. If you have one of these conditions, your physician will give you a thorough checkup before ordering the test.

In addition, many medications can make the stress test hard to interpret. If you’re taking digoxin, anti-arrythmia drugs (such as quinidine or procainamide), blood pressure medications or tricyclic antidepressants, the test may be less accurate than usual.

Alternative methods to assess your heart are available if for some reason the treadmill test can’t be done. If a stress test isn’t right for you, your doctor may suggest cardiac catheterization, which uses a special dye and X-rays to show the inside of your arteries.

Another test, a computed tomography (CT) scan, uses electron beams to find calcium deposits in heart arteries, which may be an indication of heart disease.

— Source: HealthDay.

Support Noozhawk Today

You are an important ally in our mission to deliver clear, objective, high-quality professional news reporting for Santa Barbara, Goleta and the rest of Santa Barbara County. Join the Hawks Club today to help keep Noozhawk soaring.

We offer four membership levels: $5 a month, $10 a month, $25 a month or $1 a week. Payments can be made through Stripe below, or click here for information on recurring credit-card payments and a mailing address for checks.

Thank you for your vital support.

Become a Noozhawk Supporter

First name
Last name
Enter your email
Select your membership level
×

Payment Information

You are purchasing:

Payment Method

Pay by Credit Card:

Mastercard, Visa, American Express, Discover
One click only, please!

Pay with Apple Pay or Google Pay:

Noozhawk partners with Stripe to provide secure invoicing and payments processing.

  • Ask
  • Vote
  • Investigate
  • Answer

Noozhawk Asks: What’s Your Question?

Welcome to Noozhawk Asks, a new feature in which you ask the questions, you help decide what Noozhawk investigates, and you work with us to find the answers.

Here’s how it works: You share your questions with us in the nearby box. In some cases, we may work with you to find the answers. In others, we may ask you to vote on your top choices to help us narrow the scope. And we’ll be regularly asking you for your feedback on a specific issue or topic.

We also expect to work together with the reader who asked the winning questions to find the answer together. Noozhawk’s objective is to come at questions from a place of curiosity and openness, and we believe a transparent collaboration is the key to achieve it.

The results of our investigation will be published here in this Noozhawk Asks section. Once or twice a month, we plan to do a review of what was asked and answered.

Thanks for asking!

Click Here to Get Started >

Reader Comments

Noozhawk is no longer accepting reader comments on our articles. Click here for the announcement. Readers are instead invited to submit letters to the editor by emailing them to [email protected]. Please provide your full name and community, as well as contact information for verification purposes only.

 

Special Reports

Heroin Rising
<p>Lizette Correa shares a moment with her 9-month-old daughter, Layla, outside their Goleta home. Correa is about to graduate from Project Recovery, a program of the Santa Barbara Council on Alcoholism & Drug Abuse, and is determined to overcome her heroin addiction — for herself and for her daughter. “I look at her and I think ‘I need to be here for her and I need to show her an example, I don’t want her to see me and learn about drugs’,” she says.</p>

In Struggle to Get Clean, and Stay That Way, Young Mother Battles Heroin Addiction

Santa Barbara County sounds alarm as opiate drug use escalates, spreads into mainstream population
Safety Net Series
<p>Charles Condelos, a retired banker, regularly goes to the Santa Barbara Neighborhood Clinics for his primary care and to renew his prescription for back pain medication. He says Dr. Charles Fenzi, who was treating him that day at the Westside Clinic, and Dr. Susan Lawton are some of the best people he’s ever met.</p>

Safety Net: Patchwork of Clinics Struggles to Keep Santa Barbara County Healthy

Clinics that take all comers a lifeline for low-income patients, with new health-care law about to feed even more into overburdened system. First in a series
Prescription for Abuse
<p>American Medical Response emergency medical technicians arrive at Santa Barbara Cottage Hospital with little time to spare for victims of prescription drug overdoses.</p>

Quiet Epidemic of Prescription Drug Abuse Taking a Toll on Santa Barbara County

Evidence of addiction shows an alarming escalation, Noozhawk finds in Prescription for Abuse special report
Mental Health
<p>Rich Detty and his late wife knew something was wrong with their son, Cliff, but were repeatedly stymied in their attempts to get him help from the mental health system. Cliff Detty, 46, died in April while in restraints at Santa Barbara County’s Psychiatric Health Facility.</p>

While Son Struggled with Mental Illness, Father Fought His Own Battle

Cliff Detty's death reveals scope, limitations of seemingly impenetrable mental health system. First in a series