Exercise Stress Test
In some cases, EKG irregularities can only be identified during exercise or while symptoms are present. An exercise stress test demonstrates the effect that exercise and physical activity has on the heart. In many cases, the exercise stress test is performed to determine the causes of chest pain and/or to identify rhythm abnormalities during exercise.
A standard stress test involves the patient walking on a treadmill or pedaling a stationary bike while being monitored by an electrocardiogram and blood pressure readings to measure the heart’s response to the body’s increased need for oxygen.
The patient continues the test until a target heart rate is reached, unless chest pain or a dramatic rise in blood pressure occurs. The heart will continue to be monitored for several minutes after exercising.
Nuclear Stress Testing
A nuclear stress test demonstrates how well blood flows into the heart muscle cells when it is at rest versus during increased activity. A physician may recommend a nuclear stress test to diagnose coronary artery disease, examine the size and shape of your heart, and guide treatment of existing heart disorders.
A radioactive tracer is injected into a vein, and during the scan a camera takes pictures of the heart revealing how well the tracer travels through the coronary arteries and into the heart muscle. Areas not absorbing the tracer may not be receiving adequate blood.
Two scans may be performed during nuclear stress testing; one while resting and one while the heart is stressed by exercise or medicine. The images are then compared.
An echocardiogram (ultrasound test of the heart) is a non-invasive test that uses sound waves to create a real-time image of the heart. The high frequency sound waves use no radiation and provide detailed pictures of the valves and chambers. This aids the physician in determining appropriate treatment.
Echocardiograms produce images that show:
- Heart defects
- Valve problems
- Damage to heart muscle
- Heart size
- Heart pumping efficiency
A physician may recommend an echocardiogram if he or she suspects a problem involving the patient's valves, chambers or pumping strength.
Stress echocardiography combines elements of both an echocardiogram and the standard exercise stress test. This test identifies the heart’s reaction during periods of rest and physical activity. When the two tests are administered together, your doctor can assess the status of your heart at rest compared to your heart during and immediately following stress.
A stress echocardiogram may be performed to help in the diagnosis of coronary heart disease and the presence of blockages in the coronary arteries.
When a patient experiences irregular heart rate, dizziness, shortness of breath, chest pain, abnormal pacemaker function or fainting and/or falling spells, a Holter monitor may be recommended to monitor and record heart rhythms over a 24 hour period.
Worn by the patient, the Holter monitor is a portable EKG device that monitors the electrical activity of a person’s heart during normal activity. Following the 24 hour period, the patient brings the monitor back to his or her physician, and a technician scans through the thousands of beats and generates a report of irregular rhythms or rates.
An event recorder is a type of testing that allows a patient to record periods of electrical activity of the heart over a period of several weeks. The procedure is performed to identify abnormal beats and heart rhythms; evaluate your symptoms in relation to your heart beat; monitor pacemaker or defibrillator activity; and assess if your medications are related to your symptoms over a long period of time.
The event recorder test allows for on-demand heart monitoring during a patient’s normal activities. When the patient experiences an episode of dizziness, weakness or palpitation, he or she will push the button on the device, which stores the data. Following the testing period, the monitor is returned to your physician to record data.
Electrophysiology studies, or EPS, is used to identify the cause of an abnormal heart rhythm (arrhythmia). EPS shows how the heart reacts to controlled electrical signals. These signals can help doctors locate the source of the arrhythmia and determine the best way to treat the irregular heart rhythm.
Tilt Table Testing
When a patient is experiencing episodes of fainting, a doctor may suggest tilt table testing.
The tilt table test is administered to help determine how the body responds to changes in position and susceptibility to faint by reproducing the symptoms. The patient is connected to ECG and blood pressure monitors while lying on a table that tilts in various directions. The test helps identify if the patient is prone to sudden drops in blood pressure or slow pulse rates.