Stress Test (Treadmill Stress Test)

Cardiac Diagnostic Test to evaluate:

Heart function and functional capacity of heart

 

Abnormalities of the heart or heart rhythm during exercise

 

The presence or absence of heart disease

 

The supply of blood to the heart during exercise

 

Symptoms such as chest pain or shortness of breath

 

Types of Stress Tests:

Standard Stress Test (Treadmill)

 

Nuclear Stress Test – Myoview or similar isotope (Treadmill)

 

Nuclear Stress Test – Adenosine (Pharmacologic/Medication)

 

Procedure:

  • Consent form for Stress test is reviewed and signed
  • You will be instructed by the EKG Tech to remove clothing from waist up and will be provided with a gown
  • Areas of your chest will be cleansed with an abrasive alcohol pad
  • 10 Electrodes (adhesive patches) are placed on chest, connected to wires and attached to Stress Machine
  • EKGs will be performed at rest, sitting and during hyperventilation
  • Demonstration of walking on the treadmill will be provided by EKG Tech
  • Cardiologist will review indication for stress test, your symptoms and answer any questions you may have regarding the test
  • Baseline Blood Pressure is obtained and BP cuff remains in place on arm throughout test
  • You will be assisted to the treadmill and exercise begins
  • Treadmill speed and height will increase every 3 minutes (EKG Tech will inform you prior to treadmill change)
  • The Cardiologist monitors your Blood Pressure and EKG, continuously.
  • Stress test continues until either you need to stop, you reach the target heart rate predicted for you or until the test is stopped by the Cardiologist
  • After the test, you will be monitored for several minutes until heart rate, blood pressure and EKG return to pre test levels

 

Preparation for Test:

  • Nothing to eat or drink 6 hours prior to test
  • No Smoking on day of test
  • Take your current medications UNLESS instructed by your Physician
  • Wear comfortable, flat shoes/sneakers and loose fitting clothing, appropriate for exercise
  • Please bring a list of medications you are currently taking
     

NUCLEAR STRESS TEST (Treadmill)

A diagnostic test to evaluate chest pain or shortness of breath, to detect the presence of early heart disease, to assess your functional capacity or to update the status of your coronary circulation following a cardiac event. You will receive an intravenous injection of Myoview or a similar isotope, a radioactive tracer that identifies areas of decreased blood flow to the heart muscle caused by heart disease. There are no harmful effects from the radioactive substance.

Procedure:

  • After the consent form has been signed, an intravenous is started in your arm for use throughout the entire test, approximately 5 hours. Please remain on The Cardiology Group Office premises throughout entire test.
  • After the IV has been started, you will receive the Myoview or similar isotope injection and then wait 30-60 minutes. The first set of heart scans will be taken. During this 15 minute scan, you will be asked to position your arms over your head. There is a 2 hour wait period after the first set of scans.
  • After the first scan, ECG electrodes will be placed on your chest. You will be connected to the Stress Monitor and a series of ECGs will be taken before, during and after exercise.
  • You will be asked to walk on the treadmill until you reach your maximum heart rate or you need to stop exercise. During exercise, the treadmill will increase in speed and elevation, every 3 minutes. The length of time for your exercise test will depend on your exercise tolerance.
  • One minute prior to the completion of exercise, Myoview or a similar isotope will be injected into the IV. You will then exercise for a full minute after the injection to circulate the Myoview or similar isotope.
  • After exercise, you will have an additional scan for approximately 12 minutes.

 

Reminders and Preparation:

(IN ORDER FOR YOU TO BE APPROPRIATELY PREPARED FOR YOUR TEST - PLEASE READ ALL REMINDERS PRIOR TO TESTING)

**VERY IMPORTANT: IF YOU ARE UNABLE TO KEEP THIS APPOINTMENT, PLEASE CALL THE CARDIOLOGY GROUP, P.A. OFFICE 48 HOURS PRIOR TO TESTING at 408-293-1992**
 

  • Please bring all medications you are currently taking on the day of your test.
     
  • NOTHING TO EAT OR DRINK 6 HOURS PRIOR TO TEST*** FAILURE TO FOLLOW THIS INSTRUCTION WILL RESULT IN CANCELLATION OF TEST*** You may take morning medications with a small amount of water
  • No caffeine or nicotine on the day of test.
  • Please wear comfortable clothing and shoes- including a SHORT SLEEVE SHIRT/BLOUSE.
  • IMPORTANT: If you are Diabetic, please contact our office for specific instructions for diet and/or Insulin and other Diabetic medications prior to testing.
  • If you are pregnant or currently nursing, please inform your physician or technologist before this study is performed.
  • If there is any possibility you may be pregnant, please notify the Cardiology Group IMMEDIATELY (Test cannot be performed). If you are of childbearing age you will be asked your Last Menstrual Period-if there is any question regarding irregular or late menstrual period, you may be required to have a pregnancy test (blood test) prior to testing to safely administer this test (Pregnancy tests are not performed at The Cardiology Group office)

*IMPORTANT: PLEASE REMEMBER TO REPORT FOR TESTING AT THE TIME PROVIDED TO YOU. This test is timed for each patient. Reporting late (15 MINUTES or more) will result in rescheduling test. Thank you for your cooperation!

 

Pharmacologic Stress Test

Your physician has ordered pharmacologic (,AdenosineTM, LexiscanTM or "medication") Stress Test, to evaluate chest pain (or other worrisome symptoms), to detect the presence of heart disease and/or to evaluate the degree of damage following a heart attack. This test does not require you to perform vigorous physical exercise on a treadmill. You may be asked to perform mild physical activity (as you are able) such as hand grip, leg kicking (while seated) or walking very slowly on a treadmill.  An intravenous (IV) will be started before the test.  A medication will then be given through the IV to simulate certain physiologic changes that occur with exercise.  These medications usually DO NOT result in significant changes in heart rate (demand on the heart) but rather increase the heart's blood flow (supply) by dilating the blood vessels of the heart. You will also receive an intravenous injection of a small amount of radioactive medicine (MyoviewTM, CardioliteTM and/or Thallium).  These FDA approved medications emit a small, safe, amount of radiation which is used, with a camera, to pinpoint areas of decreased blood flow to the heart muscle caused by heart disease. You will be monitored throughout the test for blood pressure, heart rate, rhythm and EKG changes. Two sets of heart scans will be taken; one at rest and one after the administration of the pharmacologic stress medication.

Procedure: Test can take up 5 hours (usually 3-4 hrs)

  • After the Stress Test consent form has been signed, an intravenous is started in your arm for use throughout the entire test.
  • You will receive the Myoview or similar isotope injection and then wait 30-60 minutes.
  • The first set of scans will be taken and will take approximately 15 minutes. There is a 2 hour wait period after first set of scans.
  • The pharmacologic stress medications AdenosineTM or LexiscanTM will be given IV. Should you experience any side effects, the antidote to the medication, Aminophylline, will be given intravenously, to promptly reverse these effects.
  • After the pharmacologic stress medication is given, Myoview will be injected. After 30-60 minutes, a second set of heart scans will be taken and will take approximately 12 minutes.
  • Bring all medications you are currently taking on the day of your test.

 

NOTHING TO EAT OR DRINK 6 HOURS PRIOR TO ARRIVAL TIME

No Nicotine on the day of test.

NO CAFFEINE PRODUCTS FOR 24 HOURS PRIOR TO TEST such as : Coffee-with and without caffeine; all forms of tea-with or without caffeine; chocolate; all cola beverages (including sugar-free and decaffeinated) which include: Dr. Pepper, Ginger Ale, Mountain Dew, Orange Crush, Root Beer

PLEASE NOTE** Test will be cancelled if caffeine is consumed within 24 hours of test **

MEDICATIONS CONTAINING CAFFEINE should be avoided 24 hours prior to test such as: Medications for Migraines, Pain medications-Percocet, Darvon Compound, Fiorinal. Anacin, Excedrin

IMPORTANT: If you are Diabetic, contact our office for specific instructions for diet and/or medication (such as Insulin and other Diabetic medications) prior to testing. Please bring a Snack on day of test.

If any medications need to be withheld prior to testing, a Technician will contact you. If you are taking a diuretic (water pill), hold AM of test and take after test is done.

If you have lung problems such as asthma, emphysema or COPD, please inform the nurse/tech prior to the test
 

If you have claustrophobia, or have been claustrophobic before during medical testing, please notify the Cardiology Group staff (scanner used for this test does not encircle you, however, the scanner comes close to your face/chest during scanning).

If there is any possibility you may be pregnant, please notify the Cardiology Group IMMEDIATELY (Test cannot be performed). If you are of childbearing age, you will be asked for the date of your Last Menstrual Period (LMP).  If there is any question regarding irregular or late menstrual period, you may be required to have a pregnancy test (blood test) prior to testing to safely administer this test (Pregnancy tests are not performed at The Cardiology Group office)
 

DO NOT take alcohol, tranquilizers or sedatives prior to testing.