Cardiac Stress Testing Overview

Developed over 50 years ago, stress testing has an established academic and well-defined clinical role in cardiovascular medicine. Physicians use stress testing for the evaluation of concerning symptoms and to determine prognosis. All physicians who perform stress tests in our office are board-certified to do so.

Conventional exercise stress tests are performed using an exercise treadmill. Vital signs and real-time electrocardiograms (ECG) are monitored, and a board-certified cardiologist is continuously present. Patients walk on a treadmill until a predetermined target heart rate is reached. Exercise is performed using standardized protocols in which the speed and elevation of the treadmill are gradually increased. The test may be terminated early at the physician’s discretion if there are concerning symptoms or ECG changes.

For patients who are unable to perform exercise on a treadmill, cardiac stress testing can be accomplished with the assistance of intravenous agents. Most commonly, dobutamine or regadenoson (Lexiscan®) are used to simulate exercise. These agents have short half-­lives, which means that the body metabolizes and eliminates them very quickly, typically well before patients have left the office.

The diagnostic accuracy of stress tests can be further increased with additional cardiac imaging techniques, including echocardiography (Exercise Echocardiography) and nuclear imaging (Myocardial Perfusion Imaging). There are many instances where it is appropriate to include cardiac imaging as part of your stress test. Our cardiologists will let you know which test is correct for you.

Patient Instructions Before Testing and Procedures