Treadmill exercise test

Treadmill Stress Test helps to determine risk of heart disease (coronary artery disease, blocks in arteries that carry blood to the heart muscle).

It basically checks how the heart responds to a certain level of physical activity and if the blood flow and oxygen supply to heart is affected by exercises/physical activity.

Why is it advised by doctors?

  • To know if the source of symptoms such as chest pain, difficulty in breathing, dizziness, etc. is due to a heart disease.
  • To assess risk of coronary heart disease in individuals with risk factors such as obesity, Diabetes, previous heart attack, irregular heart beat, hypertension, old age, etc.
  • To make sure the prescribed medications for hypertension, heart disease, etc. are working well.
  • To monitor treatment and as a follow up after heart procedures to improve circulation to heart in individuals with coronary artery disease.
  • To study and diagnose irregular heart rate and rhythm (arrhythmia).
  • To assess acceptable level of physical activity or exercises.

Pre-requisites before the test:

The following instructions may be given by the doctor before coming in for the test.

  • Do not eat food except water at least for 4 hours before the test.
  • Do not drink caffeinated drinks at least 12 hours before the test.
  • Certain medications are not to be taken on the day of test. Keeping the doctor informed of all the medications, you are taking regularly is important. This may help the doctor advise against certain medications on the day of test, if needed.
  • Do not stop taking any prescribed medication without informing the doctor.
  • Keep the doctor informed if medical conditions such as Diabetes are diagnosed. If one is on insulin, dose may be advised to be decreased before the test. Discussing the same with the doctor beforehand is important.
  • If one is asthmatic and is on inhaler, it is best to bring it to the test.
  • Wear loose comfortable clothes and shoes while going for the test.
  • Inform the doctor if any of the symptoms such as chest pain, shortness of breath, etc. are experienced on the day of the test.

What happens during the test?

  • Few places over chest may be cleaned gently to place small patches of leads (electrodes) over skin of chest, that helps in detecting electrical activity of heart as a part of ECG (ElectroCardioGram) during the test.
  • Blood Pressure (BP), Heart Rate (HR), ECG readings are taken at rest before starting the test. These are closely monitored throughout the test. If one is Diabetic, blood glucose levels are also checked.
  • The test is started by walking on treadmill or pedaling on stationary cycle and its speed is increased gradually. It can stopped whenever one is not comfortable. Tell the medical personnel if symptoms such as chest pain, shortness of breath, dizziness, discomfort of left arm/shoulder, etc. are experienced during the test.
  • It is normal to experience symptoms such as pounding heart with increased heart rate, blood pressure, breathing rate, sweating.
  • The test is later gradually stopped by cooling down physical activity with slow speed of treadmill/pedaling until the monitored BP, heart rate, ECG readings come back to normal.
  • It may take about 7-15 minutes for the test to complete and one can take some rest, drink water after the test.

What does the test result mean?

Treadmill stress test helps in estimating more or less likely chances of coronary heart disease and determining function of heart muscle in pumping blood effectively throughout the body but it doesn’t confirm/rule out the same.

 

  • Abnormal test result- Indicates there is a possibility for one or more arterial blocks and  further tests may advised to confirm/rule out coronary heart disease.

 

It may also detect heart rhythm abnormalities

References:

https://www.health.harvard.edu/heart-disease-overview/cardiac-exercise-stress-testing-what-it-can-and-cannot-tell-you

http://www.heart.org/en/health-topics/heart-attack/diagnosing-a-heart-attack/exercise-stress-test

https://www.healthline.com/health/exercise-stress-test

https://www.webmd.com/heart-disease/guide/stress-test#1
By,
Dr. Divya Teja

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