Stress Test

Is designed to detect a mixmatch between:

1)      Oxygen demanded by the heart muscles versus;

2)      Blood supplied to the heart muscles.

A mixmatch will only occur if a vessel has a blockage greater than 70%.

This test requires about 4 hours in the office. So please bring a snack that you may eat after the second part of the test.

Before the test:

Do not eat or drink anything except water for 6 hours before your test is scheduled.

Do not eat or drink anything with caffeine for 24 hours (one day) before your test.

This includes:

  • Coffee (even decaf)
  • Tea (even decaf)
  • Soda
  • Chocolate
  • Sports drinks
  • Some foods and supplements
  • As well as medication such as Anacin, Excedrin, Darvon and Fiorinal.

Do not smoke/chew tobacco for 6 hours prior to your test.

During your office visit your doctor will tell you the type of stress test that is being performed (exercise or chemical). The doctor will also inform you as to which of your prescribed medications are appropriate to take before your stress test.

Wear comfortable, loose-fitting clothes and walking shoes. We will need access to your chest for EKG placement and wearing a loose-fitting top will make the test more comfortable. Shoes with high heels or no straps on the back, flip-flops, boots ect. are dangerous on a treadmill; please do not wear these types of shoes on the day of your stress test.

If you have diabetes and are taking insulin, ask your doctor if you need to change the amount of insulin that you are taking. You will also want to bring juice, hard candies ect, for if there is a need during the test.

Stop taking sildenafil citrate (Viagra) for 48 hours (two days) before this test. If you have chest pain during this test, you may be given medicine called nitroglycerin to treat it. This medication can cause very low blood pressure in people who have recently taken Viagra.

 

Technique:

There are two components to every stress test.

1)      Stress component

2)      Imaging portion

The stress portion of this test is based on the demand for increased oxygen to the heart. There are two ways to increase the work of the heart. The first is exercise; the patient will walk on a treadmill until the patient’s heart rate reaches 85% of its maximum heart rate. This is meant to dilate the blood vessels of the heart up to 5 times their normal size. Dilating the vessels can also be achieved using medications like Adenosine, Persantine or Lexiscan. Blood vessels that are clogged with plaque do not dilate like healthy arteries. The dilated vessels steal blood from the clogged vessels.

Once the blood vessels are dilated we will move to the imaging portion of the test. The patient will be injected with a minute amount of radioactive dye that “lights up” the heart muscles. The types of radioactive material injected are Thallium, Cardiolite or Myoview are safe; except in pregnant patients.

When the vessels dilate there is increased blood flow to the heart; on these images increased blood flow is shown by the heart “lighting up”. These light areas of the heart are being adequately supplied with blood. Muscles that are not receiving adequate blood supply are seen as a dark shadow.

1)    The technician will place an IV access port; Usually in the hand or in the arm.

2)    You will be asked questions about your medical history and thoroughly explain the test at this time.

3)    You will receive two injections of a Radiopharmaceutical “Tracer”. This tracer does not contain iodine and will not affect how you feel.

4)    Images will be taken with you sitting in a chair and your arms will be resting on a tray that is in front of you. It is important that any items such as jewelry and reading glasses are removed as they may interfere with your images.

5)    Once initial images are complete, we will prepare you for the stress portion of the test, (either treadmill or chemical exercise)

6)    Your heart rate and blood pressure will be monitored while we are conducting the test. Please communicate with the technician if you are experiencing any difficulties during the test.

7)    A second dose of the Radiopharmaceutical “tracer” will be administered through your IV while you are exercising.

8)    After the exercise portion of the test, you will most likely have a brief wait. During this time, you may eat/drink and resume your normal medication schedule. Remember to bring a snack and something to drink.

9) Finally, you will go back on the camera for a second set of images. Once complete, your IV access port will be removed and the test is finished.

 

After the Test:

After you’re finished with the stress test you will return back home and maintain your normal life style. After your test we will schedule a follow up appointment so Dr. Baiju can explain the results of the test.