In many patients, the first symptom of coronary artery disease is a heart attack, with no preceding chest pain as a warning. “For this reason, physicians perform screening tests to identify the condition before serious medical events occur,” David Bush, M.D., cardiologist at Our Lady of Bellefonte Hospital, said. “These screenings are particularly important for patients with one or more risk factors for heart disease.”

Risk factors for heart disease and coronary artery disease include a family history of heart disease, elevated cholesterol levels, smoking, high blood pressure, physical inactivity, obesity, and diabetes.

Screening Tests

An initial screening for coronary artery disease can involve stressing the heart under controlled conditions. These tests enable physicians to determine the severity of blockages in the arteries.

“There are two types of stress tests – tests that involve exercising the patient to stress the heart (exercise cardiac stress tests), and those that chemically stimulate the heart to mimic the stress of exercise (physiologic or drug-induced stress testing),” Bush explained. “Physiologic stress is used for patients who are unable to exercise.”

OLBH Offers Exercise Stress Tests and Stress Echocardiograms

The exercise stress test, also known as a stress echocardiogram or stress echo, is performed in the OLBH Cardiology Department and involves walking on a treadmill with progressive increases in speed and elevation, usually at three-minute intervals. “As the body works harder during the test, it requires more oxygen, so the heart must pump more blood,” Dr. Bush said. “During the exam, we can determine if the blood supply is reduced in the arteries that supply the heart, a sign that there may be blockage.”

During the Test

Electrodes (conductive patches) are placed on the chest, arms, and legs to record activity of the heart. A blood pressure cuff is placed on the arm and is inflated every few minutes. Heart rate and blood pressure measurements are taken before exercise starts.

“During exercise, an electrocardiogram (EKG) is used to record the activity of the heart and blood pressure readings are taken,” Dr. Bush added. “The response of the heart to increased exercise is monitored. The test continues until a target heart rate is reached, unless chest pain or an exaggerated rise in blood pressure occurs.” Monitoring continues for about 10-15 minutes after exercise stops.

“Patients should not be concerned about the difficulty of the test,” Bush said. “Each patient’s age and physical condition is taken into account when determining the level of the test. If needed, patients can stop the test at any time.”

Why the Test is Performed

A stress test is performed to diagnose coronary artery disease; determine causes of chest pain, shortness of breath, or lightheadedness; determine the exercise capacity of the heart; and predict the risk of heart-related conditions such as heart attack. There also may be other reasons for your physician to recommend this test.

Depending on the results of the stress test, additional testing such as a nuclear stress test in the OLBH Cardiology Department, or cardiac catheterization at OLBH, may be recommended.

Speak to your physician for further information about heart-related illnesses. If do not have a family doctor, the OLBH CareLine can refer you to one who meets your needs; simply dial (606) 833-CARE (2273), or e-mail: careline@bshsi.org.