How to Prepare: Cardiac Stress Tests

Keeping on top of cardiovascular health is extremely important. Regular checkups allow physicians to detect changes in one’s heart health. If something seems suspicious, a doctor may order a cardiac stress test.

Helen Shores Peters, Radiologic Technologist and Certified Nuclear Medicine Technologist in Pullman Regional Hospital's Imaging Department, shares information about the different types of stress tests and what each entails.

Types of Cardiac Stress Tests

Peters categorizes cardiac stress tests into three different groups:

• Exercise Tolerance Test (ETT): a simple treadmill-only test. This test is primarily ordered when a patient is experiencing exertional chest pain. It shows if there are any electrical or blood pressure changes when the patient exercises at a certain level of heightened heart rate (at least 85% of max heart rate). Among patients who cannot tolerate the treadmill, a chemically-based alternative is available.
• Nuclear Stress Test: “That's a big fancy word. We get a lot of people who are like, ‘Whoa, what are we doing?’ But, the process is just nuclear imaging in addition to the treadmill stress test,” states Peters. “It’s a little more involved and shows a bit more than the treadmill only because we're actually able to, with the introduction of the radioisotope, see the blood flow to the heart with our imaging. So, it's a really good stress test for when physicians are wondering if some of their patient’s symptoms are due to an inadequate blood flow to their heart muscle.”
• Stress Echocardiogram: This test involves the treadmill, but it has ultrasound imaging. This test primarily looks at heart structure.

How to Prepare for the Stress Test

It’s important patients abstain from any caffeine prior to the cardiac stress test. One reason is that caffeine can increase blood pressure and heart rate. “We want a solid baseline. So, we don't want the heart rate to be obscured by caffeine in the system,” explains Peters. An additional reason is that if a person is undergoing the chemical stress test, caffeine is the “antidote” to that medication. It doesn't allow the vessels to dilate as they should.

Peters also notes that it’s helpful for patients to bring a list of their regular medications and to dress comfortably (e.g. sweatpants, short sleeve shirt, and comfortable walking shoes). Post stress test, patients can resume everything as normal. Results are typically available in about 24-48 hours via a patient's MyChart online health portal.

Don’t Let Fear Stop You

Many people are nervous or anxious about undergoing a cardiac stress test, but Peters assures there is nothing to be concerned about. She urges people to do everything they can to make sure their heart is healthy and strong.

“We have a lot of patients who have lost sleep, who have a lot of high anxiety. I just want to encourage anyone who is maybe thinking about having this test or has had it ordered and just hasn't gotten a lot around to doing it that it is a pretty easy test. We do these all the time. If anybody has any questions, we have no problem talking to them beforehand. We don't want people to lose sleep over this and be stressed out and not get the tests they need because they're so anxious about it.”

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