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How Long Does An Ekg Stress Test Take

How Long Does An Echocardiogram Take Special Cases

Medical Minute: Stress Test – What to Expect

When considering how long does an echocardiogram take, its often dependent on if special tests are added on such as a stress echocardiogram. Patients will be made aware beforehand if this is the case. A stress echocardiogram may take up to an extra 20 minutes depending on the type of stress. In some cases patients will exercise on the treadmill prior to the echocardiogram pictures being taken. In some cases patients will receive medicine through an IV to increase the heart rate and the pictures taken while various doses of medicines are given. In some cases, there may be special findings on an echocardiogram that mean extra attention to detail and pictures are required, this will of course add time to the test.

St Segment Elevation During Exercise Stress Test

ST segment elevation during exercise stress testing is measured in the J-60 point . In patients with ST elevations on the resting ECG , any additional ST elevation induced by exercise is measured from the initial level of the J-60 point .

The implication of ST elevations during exercise depends on whether they occur in leads with or without pathological Q-waves.

What Should I Wear On The Day Of The Test

Please wear or bring comfortable clothes and shoes suitable for walking. Please do not bring valuables. You will be given a locker to store your belongings during the test.

  • Your test will take place in the Stress Lab. The testing area is supervised by a physician.
  • First, a stress lab technician will gently rub 10 small areas on your chest and place electrodes on these areas. The electrodes are attached to an electrocardiograph monitor that charts your hearts electrical activity during the test.
  • Before you start exercising, the technician will perform a resting EKG, measure your resting heart rate and take your blood pressure.
  • You will exercise on a treadmill. The lab personnel will ask you to start exercising and will gradually increase the intensity of exercise. You will be asked to continue exercising until you are exhausted.
  • At regular intervals, the lab personnel will ask how you are feeling. Please tell them if you feel chest, arm or jaw pain or discomfort short of breath, dizzy, lightheaded or if you have any other unusual symptoms.
  • The lab personnel will watch for any changes on the EKG monitor that suggest the test should be stopped.
  • After the test, you will walk slowly for a few minutes to cool down. Your heart rate, blood pressure and EKG will continue to be monitored until the levels are returning to normal.

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Why A Stress Test Is Done

Your doctor may order a stress test to:

  • Diagnose coronary artery disease This disease develops when the coronary arteries become damaged or diseased usually due to a buildup of plaque or cholesterol deposits.
  • Detect heart rhythm problems Arrhythmias occur when the electrical impulses that coordinate your heart rhythm malfunction. This causes your heart to beat too fast, too slowly or irregularly.
  • Inform treatment of heart disorders If youve been diagnosed with a heart condition, a cardiac stress test can show your doctor how well treatment is working. He or she may also use test results to develop your treatment plan by gauging how much exercise your heart can handle.
  • Determine the timing and type of cardiac surgery For procedures such as valve replacement and for some people with heart failure, stress test results may help the doctor determine whether a heart transplant is needed or if other advanced therapies will be more effective.

What To Keep In Mind While Undergoing Ecg

Stress test: Types, how long it is, risks, and results

As mentioned earlier, an ECG test is a completely harmless test. There is no danger of electric shock, as no electricity passes through the patients body. The electrodes just transfer the activity of the heart as line tracings on paper.

  • All pieces of jewelry from neck arms and wrist should be removed prior to the ECG test.
  • The electrodes, when attached with the conductive gel, may give a cooling sensation on the patients chest. When the electrodes are taken off, the patient may feel a slight pull on their skin.
  • The patient can resume normal activities after the ECG test.
Written, Edited or Reviewed By:Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc.This article does not provide medical advice. See disclaimerLast Modified On: May 2, 2018

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How Is The Stress Test Helpful

Taking the stress test will help in determining whether there are any abnormalities in the functioning of the heart. In such cases, the doctor will prescribe the treatment according to the results obtained from the stress test. It will ensure that there is no excessive pressure on the heart and that the treatment is balancing the functionality of the heart during both rest and working periods.

The Stress Test Process

Once in the exercise laboratory, your doctor will attach electrodes to your arms and chest. The electrodes connect to an electrocardiogram machine, which will record your heart’s electrical activity. The EKG also monitors your heart rhythm and how fast it’s beating. The doctor will also attach a blood pressure cuff to your arm, which will tighten as it expands during the test.

Once you’re prepared, you’ll exercise on a treadmill or stationary bike. A doctor or nurse will be nearby in case you feel ill during the test. If you’re using a treadmill, you’ll start by walking in place slowly. The difficulty level will increase gradually, with the treadmill tilting up into an incline and the speed increasing to make you walk faster. Your doctor may ask you to breathe into a tube to measure the amount of oxygen you have used. On a stationary bike, you’ll start by pedaling slowly and work up to pedaling faster. The resistance may be adjusted so that pedaling is more difficult, making you and your heart work harder. You may stop the test and rest at any time if the exercise is too difficult or you feel unwell. Otherwise, it will continue until you reach a target heart rate.

If you are unable to exercise, you’ll be given medication to simulate exercise by making your heart beat faster and increasing blood flow.

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How Will I Feel During The Test

You will be encouraged to exercise until you are exhausted. It is normal for your heart rate, blood pressure, breathing rate and perspiration to increase.As you stop exercising suddenly, it is normal to feel a little unsteady when getting off the treadmill and onto the exam table for the echocardiogram.

How To Prepare For Your Test

Dr. Henry Cusnir – Getting a Stress Test

Food and medications:

You may be asked not to eat, drink or smoke for a period of time before a Cardiac Stress Test. You may need to avoid caffeine the day before and the day of the test. Please check with your doctors office or Special Testing at 617-983-7104.

Ask your doctor if you should continue taking your prescription and over-the-counter medications before the test, because they might interfere with certain Cardiac Stress Tests.

If you use an inhaler for asthma or other breathing problems, bring it with you to your test. Be sure to inform the cardiologist monitoring your stress test that you may need your inhaler during the test.

Clothing and personal items:

Wear or bring comfortable clothes and walking shoes. You will be walking at a fast pace and will need to be in proper clothing to accommodate exercise. Please do not apply oil, lotion or cream to your skin that day.

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What Can A Stress Test Diagnose

Stress tests are used to diagnose and evaluate heart problems such as ischemic heart disease, heart valve disease, and heart failure by measuring blood pressure and heart rate. The purpose of this test is to determine whether you have symptoms of a heart problem, such as shortness of breath, chest pain, dizziness, and rapid heartbeats.

Exercise Testing In Women

Heart disease is an equal opportunity problem its the number one killer of men and women in the United States. Yet, many scientific studies show that women dont get equal care they are less likely to have the appropriate testing to diagnose it, and less likely to be referred for treatment when a diagnosis of heart disease is made.

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How It Is Done

You most likely will either walk on a treadmill or pedal a stationary bicycle.

You will have a blood pressure cuff on your upper arm. Small pads or patches will be placed, like stickers, on your skin on each arm and leg and on your chest. Your doctor may wrap your chest with an elastic band to keep the electrodes from falling off.

On the treadmill, you will start out slowly in a level or slightly inclined position. After certain periods of time, the speed and steepness of the treadmill will be increased so that you will be walking faster and at a greater incline.

On the stationary bicycle, you will pedal fast enough to keep a certain speed. After certain periods of time, the resistance will be increased, making it harder to pedal.

In both tests:

  • Your EKG, heart rate, and blood pressure are recorded.
  • You might be asked to use numbers to say how hard you are exercising. The higher the number, the harder you think you are exercising.
  • The test will continue until:
  • You need to stop.
  • You have reached a target heart rate.
  • You have angina symptoms, such as chest pain or pressure.
  • You are very tired or very short of breath.
  • Your doctor feels you need to stop because of a change in your heartbeat or blood pressure.

After the test, you will be able to sit or lie down and rest. Your EKG and blood pressure will be checked for about 5 to 10 minutes.

When To Get A Stress Test

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The U.S. Preventive Services Task Force, an independent panel that makes recommendations to doctors, urges physicians not to routinely offer exercise stress testing to people without symptoms or strong risk factors for CAD. Physician groups like the American College of Cardiology support this recommendation.

The final decision, though, falls on you and a doctor who knows your health profile. “The guidelines leave a lot to physician judgment, because we’re sometimes in a gray zone where we don’t really know what’s the ‘right’ thing to do for everyone,” Dr. Bhatt says.

Although the tide has turned against exercise stress testing of otherwise healthy men concerned about their heart risk, guidelines say that a stress test could be “considered” in a man who is older and relatively inactive but embarking on a vigorous new exercise program. “In that case I would recommend a stress test,” Dr. Bhatt says.

Stress test results

An exercise stress test is designed to find out if one or more of the coronary arteries feeding the heart contain fatty deposits that block a blood vessel 70% or more. Additional testing is often required to confirm the test result.

Test result

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How Often Should You Have A Stress Test Done

    How often your doctor recommends a stress test depends partly on your risk level for heart disease. If youre at low risk and show no symptoms, such as shortness of breath or chest pain, the American College of Physicians has concluded that stress tests arent needed.

    Stress tests can have false-positive results, inaccurately indicating that theres a problem when in reality, none exists. False-positives lead to unnecessary testing, higher insurance costs, and patient anxiety.

    Whos at low risk? If youre young and healthy, dont have a family history of heart disease, exercise regularly, and eat a healthy diet, your risk is low.

    Ecg Leads To Detect Ischemia

    ECG leads V4, V5 and V6 are the best leads to detect ischemia during exercise. These leads have the highest sensitivity for myocardial ischemia, which means that the probability of detecting ischemia is highest in these leads. The limb leads are less sensitive in terms of detecting ischemia. However, ST segment depressions in lead -aVR suggest severe myocardial ischemia .

    If ST segment depressions occur early in the test, or if ST depressions are pronounced, or if ST depressions occur in many ECG leads, then there is probably extensive myocardial ischemia. The probability of multivessel disease increases with the number of leads showing ST segment depressions. Moreover, ST depressions with long duration during the recovery period also suggest more severe coronary artery disease.

    Note that some patients only display ST depressions during the recovery period. This is explained by the fact that myocardial workload increases once the patient is placed in supine position .

    Figure 5 illustrates the ECG reaction of a male with coronary artery disease.

    To distinguish normal ST depressions from ischemic ST depressions, the following rules are suggested:

  • Normal upsloping ST depressions only occur at high heart rates. Upsloping ST depressions due to ischemia occur already at low heart rates.
  • Normal upsloping ST depressions are rapidly normalized during the recovery period. Upsloping ST depressions due to ischemia are slow to normalize during the recovery period.
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    What Happens Next After My Stress Test

    Cardiologists combine the information provided by a stress test with a patients medical history and symptoms to make decisions about the need for further testing or management.

    Not every abnormal stress test requires additional testing. Some patients simply need to modify their risk factors, says Dr. Rocco. However, if the abnormality occurs at a low level of exercise, affects a large segment of heart muscle, or the pattern suggests multivessel disease, we will often proceed with cardiac catheterization.

    This article originally appeared in Cleveland Clinic Heart Advisor.

    What Are The Other Types Of Stress Tests

    Cardiac Stress Test

    Dobutamine or adenosine stress test: This is for people unable to exercise. Youâll take a drug to make the heart respond as if you were exercising. This way, the doctor can still determine if there are blockages in the arteries.

    Stress echocardiogram: An echocardiogram is a graphic outline of the heart’s movement. A stress echo can accurately visualize the motion of the heart’s walls and pumping action when the heart is stressed it may reveal a lack of blood flow that isn’t always apparent on other heart tests.

    Nuclear stress test: This helps figure out which parts of the heart are not working well. A small amount of radioactive substance will be injected into you. Your doctor will use a special camera to see rays emitted from the substance in your body. This will give them clear pictures of the heart tissue on a monitor. These pictures are done at rest and after exercise. Your doctor will be able to spot areas of your heart that arenât getting enough blood. The test could last to up to 4 hours to allow enough time for the radioactive substance to flow through your body.

    How youâll prepare for these stress tests will vary. Ask your doctor about any specific instructions.

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    How Long After A Stress Test And Ecg Will It Take To Get The Results

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    Can I Take My Regular Medications Before A Nuclear Stress Test

    Not unless your healthcare provider okays it. You may need to stop taking certain medications prior to the test. For instance, your healthcare provider may tell you not to take beta blockers, nitroglycerin, or heart medications for 24 hours before the test. You may also need to stop aspirin or blood thinners and asthma medications 48 hours before. Diabetes medication may also be restricted. Review all your medications with your healthcare provider beforehand.

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    After Your Cardiac Stress Test

    Once the treadmill has stopped and you have completed the exercise portion of the exam, you may be asked to stand still for several seconds or lie down. The staff will continue to monitor your heartrate and blood pressure. You will be allowed to leave once your heartrate and blood pressure return to your baseline readings.

    Once you have completed your exam, you may return to your normal activities, unless instructed otherwise at the time of the test by the cardiologist.

    Preparations For The Test

    Diagnostic Center in Bangalore
    • You can print and fill out the Cardiac Imaging Questionnaire, before arriving to speed the registration process.
    • Do not eat or drink caffeine products for 24 hours before exam. Note: Decaffeinated products contain caffeine.
    • Consult your physician about going off beta blockers for 48 hours and calcium channel blockers 24 hours before your exam.
    • Do not eat or drink for three hours before your appointment. Drinking water is OK.
    • If you are unable to exercise on the treadmill, a medication will be administered to stress your heart. If you are undergoing this type of an exam, you may take all your heart and blood pressure medications as instructed by your physician.
    • If you have diabetes, please speak to your physician prior to this exam to receive special instructions you may need regarding your medications.
    • For SPECT exams, wear comfortable clothes and rubber-soled shoes or sneakers for the treadmill portion of this exam.
    • Please bring all your medications or a list of them with doses to your appointment.

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