Cardiac Stress Test Procedure After Effects

Doctors rely on cardiac stress test to check out if their patients’ hearts are functioning normally. The patients would have approached a doctor with symptoms such as chest pain or shortness of breathing during physical activity. The cardiac exercise stress test is then prescribed first in which a patient is put on a treadmill connected to an electrocardiogram machine. The treadmill test would then give results about the fitness level of the patient’s heart.

The doctor may also prescribe another type of cardiac stress test called the nuclear stress test. This type of test gives more detailed information regarding heart blockages if any.

This article gives an overview of cardiac stress test – both exercise and nuclear with corresponding cardiac stress test procedure.

Exercise Cardiac Stress Test – Apparatus

A test for the heart using a treadmill is based on a very simple principle. Find out how well the patient’s heart works during physical stress such as walking.

We normally use treadmills for indoor running exercises. It is one of the most common fitness equipments to be found in gyms.

The moving conveyor belt on a treadmill can be adjusted for speed. The faster the conveyor belt moves, the faster you have to walk. The treadmill will also have an incline to provide more resistance. The speed and duration of your walking on the treadmill is measured to check your heart condition.

To use the treadmill in an exercise cardiac stress test, the treadmill machine is connected to an electrocardiogram (ECG) machine, which measures various heart indicators.

Exercise Cardiac Stress Test Procedure

The most common procedure used for treadmill test is called the Bruce protocol. This protocol advocates a seven-stage test procedure, with each stage lasting for around three minutes.

Let’s take a step-by-step look at the exercise cardiac stress test procedure.

1. Electrodes connected to patient’s skin – The heart generates electrical impulses, which are measured to measure fitness levels of the heart. Electrodes in the form of patches are connected to the patient’s chest and hooked up to an electrocardiogram machine. This way, the ECG machine records the changes in the electrical impulses from the heart as the patient exercises.
2. Resting ECG and blood pressure check - The blood pressure and heart rate are checked before running or walking on the treadmill. A blood pressure cuff will also be strapped on to the patient’s arm to monitor blood pressure as he or she exercises on the treadmill.
3. Walk in Incline at treadmill - At first, the patient walks in an incline. According to the Bruce Protocol, the first stage may start at 1.7 miles per hour (mph) and a 10% incline. At each stage of the Bruce protocol, the speed and incline is increased. For those already with heart disease or those who are older, the Bruce protocol is modified by starting with a 0% incline.
4. Stop test if any adverse symptoms – If the patient had symptoms such as drop in blood pressure or chest pain during walking on the treadmill, then the cardiac stress test should be immediately stopped.
5. Test duration and ECG recordings – The test may be stopped after a period of 20 minutes. The ECG and blood pressure can be continued to be measured some time after the test, maybe for around 15 minutes.

Cardiac Nuclear Stress Test

Your doctor may prescribe further stress tests, such as a cardiac nuclear stress test in addition to the exercise stress test.

In a cardiac nuclear stress test, radioactive material such as Thallium or Sestambi is used to measure the blood flow in the heart. These radioactive materials or dyes are injected into of the veins. The radioactive dye then travels through the blood stream and reaches the patient’s heart.

Also known as Myocardial Perfusion Imaging (MPI), cardiac nuclear stress test is more costly and definitive than a treadmill test. It measures the blood flow during no activity and during periods of physical stress. As it uses nuclear imaging, the areas where there is restricted blood flow can be definitively found out. A Thallium or nuclear stress test can also show heart condition after a cardiac operation such as bypass surgery.

Nuclear Cardiac Stress Test Procedure

Here’s how the nuclear stress test may be administered:

1. Radioactive dye injection – First the patient is asked to walk on the treadmill as in a normal treadmill cardiac stress test. When the maximum stress level has been reached, the patient is injected in the veins with Thallium or Sestambi, both radioactive dyes and tracers.

2. Scan by Gamma Camera –The patient is asked to lie down under a Gamma camera which can detect the radioactive dyes in the blood stream and heart. The Gamma camera creates images of the heart condition including blood flow indications.

3. Rest period – The patient is asked to lie in a restful state for a couple of hours as the Gamma camera takes further images. The entire test takes around 4 hours.

Cardiac Stress Test after Effects – Normal Results or Further Treatment

While after a normal exercise cardiac stress test, patients can go back to doing their normal routine, the nuclear cardiac stress test after effects may involve drinking lot of water or juices to help remove the radioactive material from the system.

If the stress test result is normal, it may still be a good idea to take precautions such as eating healthy food and doing exercises.

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Cardiac stress test after effects may involve diagnosis of heart disease for some people after interpretation of cardiac stress test results. Patients may be put on medication or may be advised surgical heart procedures such as bypass surgery or an angioplasty, based on the results and extent of blockage. The results may also indicate how well a patient is doing after a heart surgery or medication.

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