Stress Testing
Exercise Stress Test (EST) is a simple exercise test with monitoring of your heart. Stress Echo involves an additional echocardiogram (ultrasound of your heart) before and after the exercise stress test to improve the accuracy of results.
As some variables can alter the conditions of the test, it is best to call our clinic to check if you should withhold any of your regular medications. You should also refrain from smoking for 4 hours prior to the test, and avoid caffeine for two hours before your appointment time.
Each Heart of Melbourne doctor considers your specific circumstances before undertaking this test. If there are any concerns before or during the test, the doctor and cardiac the technician will be happy to discuss the issues. Your safety is the top priority for Heart of Melbourne during the procedure.
Exercise Stress Test (EST)
An exercise stress test or EST is a non-invasive test that is designed to assess how your heart, lungs, and blood vessels react to stress. The stress is simply an increased workload created by exercise while walking on a treadmill. It can provide information about your exercise tolerance, and whether there are any changes in your blood vessels, lungs, or in the electrical activity of your heart muscles.
If your GP or specialist has decided for you to take part in an EST it is usually to determine the capability of your heart and lungs to tolerate stress. This test can also help to evaluate reasons for undiagnosed chest pain, signs and symptoms of coronary artery disease (CAD), exercise capacity in patients with unexplained shortness of breath or fatigue, blood pressure response to exercise, and exercise-induced arrhythmias (heart rhythm disturbances).
At Heart of Melbourne, we ensure the highest level of safety by monitoring your heart rate and blood pressure. A blood pressure cuff will be worn on your upper arm, and electrocardiogram leads will be attached to your chest with stickers to keep an accurate record of the electrical activity of your heart. The leads will connect to a small device held on a belt around your waist during the test. The test will be gradual, and you will be required to walk on the treadmill, with increasing speed and incline, to increase your heart rate and meet the potential of your cardiac function.
You will never be expected to undergo more exercise stress than you are capable of, and you will be asked at many stages during the test if you have any discomfort or symptoms, however the higher the level of cardiac function, the more accurate your results. The test will be stopped immediately if you experience chest pain, or disproportionate shortness of breath. An experienced team with a cardiac sonographer and highly trained doctor will be present for your test to oversee the procedure and assist if needed. The entire test should take no more than 30 minutes, and you are able to return to normal activities as soon as you have completed the procedure. As the test is designed to put stress on the heart, there are always risks of changes to your cardiac function, but generally the test is very safe and Heart of Melbourne staff are highly trained and emergency equipment is readily available should they be required.
Stress Echocardiogram (SE)
An echocardiogram or 'echo' is a type of ultrasound. Ultrasound waves are used to create a moving image of your heart, which allows your doctor to assess the tissues and spaces in your heart. A stress echo or SE is a non-invasive test that is designed to assess how your heart, lungs, and blood vessels react to stress. The stress is simply an increased workload created by exercise while walking on a treadmill. It can provide information about your exercise tolerance, and whether there are any changes in your blood vessels, lungs, or in the electrical activity of your heart muscles.
The SE will be performed in 3 stages. Firstly, you will be asked to remove your top clothing and lie on the exam couch to have a basic ultrasound performed – this allows us to gain a baseline understanding of your cardiac structure. You will then be put on a treadmill, and gradually required to walk with increasing speed and incline. This will increase your heart rate and meet the potential of your cardiac function. Once this potential level is reached, you will be asked to return to the exam couch and an immediate ultrasound will be taken. During this time, you will be asked to hold your breath or alter your breathing to allow the images to be taken. This can feel uncomfortable due to the exercise undertaken, but the sonographer will be understanding and only expect you to try your best.
At Heart of Melbourne, we ensure the highest level of safety by monitoring your heart rate and blood pressure. A blood pressure cuff will be worn on your upper arm, and electrocardiogram leads will be attached to your chest with stickers to keep an accurate record of the electrical activity of your heart. The leads will connect to a small device held on a belt around your waist during the test. You will never be expected to undergo more exercise stress than you are capable of, and you will be asked at many stages during the test if you have any discomfort or symptoms, however the higher the level of cardiac function, the more accurate your results. The test will be stopped immediately if you experience chest pain, or disproportionate shortness of breath.
An experienced team with a cardiac sonographer and highly trained doctor will be present for your test to oversee the procedure and assist if needed. The entire test should take no more than 30 minutes, and you are able to return to normal activities as soon as you have completed the procedure. As the test is designed to put stress on the heart, there are always risks of changes to your cardiac function, but generally the test is very safe and Heart of Melbourne staff are highly trained and emergency equipment is readily available should they be required.
Stress Echocardiography
This test involves exercising on a treadmill for a short duration of time while monitoring your heart rhythm and blood pressure. Ultrasound images of heart are taken before and after exercise.
Please stop these medicines 48 hours before the stress test, after consulting with your doctor:
Atenolol, Sotalol, Metoprolol, Nebivolol, Bisoprolol, Carvedilol, Cardizem, Verapamil, Digoxin.
Duration: 40 minutes
Myocardial Perfusion Imaging (MPI)
Myocardial perfusion is also called a nuclear stress test. Like exercise stress echocardiogram, it is used for evaluating how well your heart performs after stress (exercise or with medication). This is done by looking at how well blood flows through (perfuses) your heart muscle. It can show areas of the heart muscle that aren’t getting enough blood flow.
This test is particularly useful if you are unable to perform exercise on treadmill or exercise bike. Instead, a medicine is injected to “stress” your heart while you are lying down.
A radioactive tracer is then injected. A special type of camera is used for this test that can detect the radioactive energy from outside the body. The camera takes images of the heart after stress and again later at rest. The two sets of images are compared.
For this test you will need to avoid caffeine for 24 hours prior to the procedure. You will also be asked to not take certain medications such as nitrates or heart slowing tablets.