Definition

Before The Test
• Prior to a stress test one should not eat or drink for a couple of hours. You should however be very well hydrated before you begin. One may also be asked to refrain from smoking prior to the test. If you are undergoing some kind of medical treatments take all your medications prior to a stress test, unless told otherwise by the physician in charge. All individuals who use heart medications and inhalers for their asthma should bring them to the stress test center. Let the doctor know if you have diabetes; since exercise can lower blood sugar, he or she may want to check your blood sugar level before the test begins.
• Comfortable loose clothes for exercising and running shoes are the best clothing items to wear for such a test.It is also recommended that you do warm up and extension exercises before you begin a cardiac stress test or any type of exercise routine. This will prevent any cramping up of the muscles being used.

During The Test
• The patient being tested for cardiac stress is connected to the electrocardiogram machine and he performs a physical exercise (for example, walking on a treadmill). A 12-lead ECG recording is made with the help of 10 standard connections.
• The exercise stress test procedure helps in comparing the status of the heart in the resting phase to that of the exercising phase. The intensity or level of exercise is increased in stages of three minutes in terms of speed (mph, km/h) and grade (% incline). The blood pressure response and symptoms of the patient are checked repeatedly.
• Those patients who are not able to perform physical exercises, can be pharmacologically exercised. In the pharmacologically induced exercise, the heart rate and its pumping force are stimulated by means of drugs like adenosine, dipyridamole or dobutamine.
• The effect of these drugs are reviewed by cardiologists through periodic blood pressure and ECG tracing checks. During this simulated 'exercise', a radiotracer (thallium-201 or technetium-99m) is injected. The gamma camera is used to take pictures after a certain period of the completion of exercise. These pictures help in comparing the status of coronary arteries when in a resting position to that in the exercise mode.
• In some of the cardiac stress test procedures, radioactive nuclides are used. Such tests are known as nuclear stress tests. The nuclear stress test procedures are capable of visualizing the relative amounts of radioisotope that are present in cardiac muscles. It helps in the accurate detection of the areas in which blood flow has decreased.

After The Test
• Once the stress test has been completed, you will be asked to walk for a while and cool down. Then you will also be asked to lie down and recover. All this still with the monitors in place. Only after the readings have returned to baseline normal will you be discharged and sent home.
• Once the test has been completed, you can resume your daily living activities closely following any indications that the doctor (s) give you. The best cool-down after the test or any exercise activity is to slowly decrease the intensity of your activity. You may also do some of the same stretching activities you did in the warm-up phase.
• As opposed to exploratory surgery, these tests are much less expensive and also involve a much lower risk towards the patient. What is even better is that there is no recovery time involved in the case of these cardiac tests. Once you have been cleared by the doctors to leave is time to go home.