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Treadmill stress test

A treadmill stress test is used to evaluate any irregular heart beats on exercise and exertion. Those suffering from borderline hypertension may be asked to undergo treadmill stress test to evaluate blood pressure response to exercise. The treadmill stress test is a cardiac stress test that is used to diagnose coronary artery disease or any heart-related ailments. Treadmill Stress Test is sometimes called an exercise electrocardiogram. The person is fitted with electrodes in about 10 locations on the arm and chest to measure blood pressure and EKG. Then the treadmill is started, initially at slow pace and later much faster. Some heart medications may be need to be stopped for a day or two. The treadmill stress test is much like any strenuous exercise such as running up a flight of stairs. It is essential that the treadmill stress test is conducted under proper supervision. This test indicates how well the heart functions and if the blood supply in the arteries is reduced on exertion. Persons scheduled for treadmill stress test must not eat or drink for about 3 hours prior to the test.

Cardiac Stress Test

A cardiac stress test aids in assessing how the heart can cope during exercise, especially when the body need for oxygen puts extra demands on the heart. A cardiac stress test is called a graded test or exercise tolerance test, exercise stress test or exercise electrocardiography. It helps to primarily evaluate the heart and vascular systems during the exercise. In fact, the American Heart Association has recommended the Cardiac stress test (EKG treadmill in particular) as the first choice to be tried on patients with medium risk of coronary heart disease and who exhibit certain risk factors of smoking, family history of coronary stenosis, high blood pressure, and high cholesterol.


  • It helps to determine whether coronary arteries are clogged or blocked.
  • To find the cause of chest pain.
  • To assess the heart's capability after a heart attack or heart surgery.
  • To discover the presence of any heart disease.
  • To set limits on a person's exercise.
  • To detect arrhythmia, that is extra heart beats, during the exercise.
  • To assess the capacity of medicine used to control chest pain or extra beats during exercise.

The cardiac stress test can be done in a clinic or a hospital. The patient may be asked to exercise using a bicycle, treadmill or arm ergometer. The patient is attached to an ECG machine. The blood pressure cuff is placed on any one arm. The patient's heart is usually monitored using a 12 - lead EKG or ECG machine. A heart monitor may be used during and after exercise. After a baseline ECG is obtained, the patient begins to perform a low level of exercise, either by walking on a treadmill or pedaling on a stationary bicycle.

At each stage of the exercise, the pulse, the blood pressure and ECG are recorded along with any symptoms that the patient may be experiencing.

The level of exercise is gradually increased until the patient cannot keep up any longer because of fatigue or until symptoms like chest pain, shortness of breath or lightheadedness prevent further exercise. The goal of this stress test is to diagnose the presence or absence of coronary artery disease. In a sub maximal stress test, the patient exercises only until a pre-determined level of exercise is attained. These tests are used in patients with known coronary artery disease, to measure whether the patient can perform a specific level of exercise with relative safety.

The side effects of a cardiac stress test also include palpitation, chest pain, and shortness of breath, headache, nausea and fatigue. The hypertension caused by stress testing is always considered abnormal and it may lead to severe coronary disease. In stress tests, false positive results are not uncommon. There can be occasions when the patient's ECG changes could suggest ischemia, even in the absence of coronary artery disease. Similarly, in stress test, false negatives are also not uncommon. In some patients, no significant ECG changes will be seen even in the presence of coronary artery disease. Presently, a new concept called nuclear perfusion study is added to the stress test. This factor has helped to minimize the limitations and improve the diagnostic capability of stress tests.


Echocardiogram

An echocardiogram is a diagnostic test that gives the doctor an idea of how the heart appears in motion. An echo uses ultrasound waves to pick up echoes from different parts of your heart. An echocardiogram throws light on the size of the heart and the condition of the heart valves. The pumping capacity of the heart is determined with an echocardiogram. Any damage to heart muscles or valves can be diagnosed with an echocardiogram. An echocardiogram is helpful in detecting any structural problems of the heart, its chambers or blood vessels surrounding it. An echocardiogram is used to detect any blood clots within the heart. This diagnostic test is used to check for causes of irregular heartbeats, enlarged heart or heart murmurs. The functioning of the heart after an attack can be checked with an echocardiogram.


Trans thoracic echocardiogram is the standard cardiogram where the doctor monitors sound wave echoes that bounce off the heart and other internal structures.

Doppler echocardiogram is based on Doppler signals that change pitch when they bounce off the heart and blood vessels. This feature is often part of other cardiogram procedures.

Stress echocardiogram is taken when a patient is undergoing a treadmill stress test.

Trans esophageal echocardiogram involves passing a probe through the throat into the chest wall. The transducer then shows clear images of the heart. This type of echocardiogram can be uncomfortable and is often performed under sedative. Trans esophageal echocardiogram is also used during surgery to monitor the heart function. Abnormal blood flow between the heart's chambers can be detected.

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Collection of Pages - Last revised Date: November 12, 2019