Treadmill Stress Test

What are treadmill stress tests?

Treadmill Stress Test, sometimes called Exercise Stress Test, is a medical examination test involving walking, jogging, and running on a treadmill. Its purpose is to get readings on a person's heart functions and overall cardiac fitness to determine if they're healthy or if they're dealing with heart problems such as coronary artery disease, heart valve disease, and congestive heart failure.

This particular test is helpful to healthcare professionals who specialize in treating heart problems because it allows them to observe patients performing physical activity and look out for signs and symptoms of heart-related issues in person, such as chest discomfort, chest pain, episodes of dizziness and lightheadedness, shortness of breath, and rapid and irregular heartbeats (arrhythmia).

By identifying these signs and symptoms, these professionals can determine what other tests to conduct that suit the patient's specific heart problems and create the appropriate treatment plans.

Why might my patients need to undergo a stress test?

If a patient presents themself with symptoms of heart problems like the ones mentioned above, it would be best for them to undergo these tests to determine if they have a specific heart problem or if they're at risk of developing one down the line, especially if they have risk factors such as their medical history showing they're at risk of developing it, if they have a family history of heart disease, if they tend to have bouts of high blood pressure, have high cholesterol because of their diet, or if they have diabetes or at risk of becoming diabetic (diabetes makes people more susceptible to heart problems).

It's more than just a diagnostic test, though. Patients who have already been diagnosed with a heart problem after undergoing this test and other assessments might be required to take this test routinely by their healthcare providers so they can monitor any changes and determine if the treatments they've planned and provided are working or not.

How does treadmill stress testing work?

What do patients need to do before undergoing treadmill stress testing?

Before a patient's scheduled treadmill test, their healthcare provider must tell them to avoid the following in the hours leading up to the test:

• They must not eat anything
• They must not smoke or use/consume any tobacco products
• They must avoid anything with caffeine for 24 hours before the test
• They must avoid using specific medication (this needs to be discussed with the provider as early as possible so they're aware of what the patient is taking)

Besides these, the provider will tell the patient to relax before and during the exam because anxiety and distress can raise the heart's electrical activity, heart rate, and blood pressure, affecting the test results.

Providers should also remind patients to wear comfortable, lightweight clothing and walking shoes.

How do healthcare providers conduct treadmill stress testing?

Once the patient is ready to take the treadmill test, the healthcare provider will do the following:

• They will take a brief medical history of the patient
• They will take the patient's vital signs, blood pressure, and heart rate while at rest
• They will attach adhesive electrodes to the patient's chest beneath the clothes. These will connected to an echocardiogram, which will be used to monitor their ECG. Resting ECG will be recorded
• After taking all of these, the provider will ask the patient if they're ready, and if they are, the provider will activate the treadmill
• The test begins with walking
• Over time, the pace of the treadmill will become faster, so the patient will have to start jogging after a while
• The test will end after 10 to 15 minutes (this should be enough time to record the necessary readings)
• After the test, the patient will be asked to lie down on an examination bed
• While the patient is in bed, the provider will monitor the patient's heart rate, blood pressure, and ECG for three to five minutes
• After gathering the data, the professional will end the whole test, and the patient is free to go. The provider will review the data, compile the results, and provide the patient with the results in a day or two

One thing for providers to note: they should ask the patient how they are now and then during the exercise portion. The test must be stopped immediately if the patient mentions feeling chest pain, dizziness, extreme fatigue, or out of breath.

What are the next steps after the stress test results have been given?

If the stress test results show normal heart rate, blood pressure, and ECG throughout the examination, then the patient's all good.

Suppose any abnormalities are detected throughout the test, like high blood pressure spikes, abnormal ECG, and high or low heart rates. In that case, the healthcare provider will have the patient undergo more tests to determine the problem causing it, such as Stress Echocardiogram, Nuclear Stress Test, and Cardiac Catheterization.

Please note that what counts as normal and abnormal will depend on the patient's age and fitness level, and the baseline measurements for normal vary from provider to provider.

What are the different types of cardiac stress tests?

Besides the Treadmill Stress Test, patients can undergo other stress tests. Depending on the treadmill test results, the healthcare provider might have patients undergo these tests for consistency and to narrow down potential problems.

Stationary Bike Cardiac Stress Test

Exercise Stress Tests use either a treadmill or stationary bicycle to examine their patients. The treadmill is the more popular, but the stationary bike version works well.

Those taking the test will also be hooked up to an ECG, and the healthcare provider will do the same thing if they're conducting the treadmill test. This time, the patient will pedal at a slow pace. Over time, the speed of the pedaling or the resistance of the pedals will increase. This forces the patient to exert more effort in pedaling, which adds to the heart's workload.

Nuclear Cardiac Stress Test (Cardiac PET Study)

This type of stress test is also an imaging test. It involves providing a patient with a radioactive radiotracer through an IV. A PET scan will show how the radiotracer moves inside the arteries, and through its movements, healthcare providers can detect which parts of the heart have poor blood flow or which parts have been damaged.

Pharmacological Stress Test

This stress test involves medication like Dobutamine for increasing heart rate and Vasolidators to increase blood flow. Suppose a patient is unable to exercise for whatever reason. In that case, healthcare providers will often resort to this and include it as part of a Cardiac Nuclear Stress Test to determine what potential heart problems the patient has.

You can use this nuclear stress test template and stress test template can improve your practice and client experiences.