Ask the Experts

What Should I Know About a Stress Test?

dr. david j. weinreich
David J. Weinreich, MD, FACC
More about Dr. Weinreich

What is a stress test?
A stress test is a diagnostic study used to either make a diagnosis of coronary disease or to help guide treatment of coronary heart disease. 

 

What kind of stress tests are there?
There are several different kinds of stress tests. The most commonly performed stress test is a treadmill study performed while walking and being monitored for EKG changes. The treadmill test measures heart rate, blood pressure response, and exercise capacity. Treadmill tests can be performed with or without use of an imaging agent. The imaging agent can improve the accuracy of the study.

Another commonly performed stress test is the pharmacological type. This non-walking stress test measures blood flow to the heart muscle under stress. About 40 percent of the stress tests are performed using drug induced challenges and are useful in individuals not capable of walking due to other health issues, such as orthopedic problems or stroke. Pharmacological stress tests always include imaging, usually using a nuclear isotope.

 

Who should have a stress test?
Stress tests are commonly performed to evaluate complaints of chest discomfort or other symptoms that are suspicious for coronary artery disease. Routine stress tests are generally 60-70 percent accurate. When a nuclear agent is added, the test is more than 90 percent accurate.

 

Are stress tests safe?
They are very safe. The rate of death is less than 1 in 10,000. Appropriate resuscitation equipment and qualified personnel are required in laboratories performing stress testing.  The nuclear version does carry a small dose of radiation exposure, which does add a wealth of information to the study. The nuclear imaging version is often better for indicating the extent of disease.

 

Why shouldn’t we skip a stress test and go right to cardiac catheterization?
Cardiac catheterization is an invasive study and carries the possibility of serious complications. It is used if an unstable condition is present, or if a stress test is markedly abnormal, or if surgical treatment is being planned. Stress tests help doctors know whether there is a compelling reason that warrants an invasive study.


Dr. Weinreich was voted "Physician of the Year" by Vassar Brothers Medical Center and serves as President of the Medical Staff. He also was recognized with an Outstanding Service Award for Quality Improvement in Hospital Cardiology by the American Heart Association. A graduate of Franklin and Marshall in Lancaster, Pennsylvania, he subsequently received his medical degree from Hahnemann University in Philadelphia, Pennsylvania, also completing his internship and residency there. His fellowship in cardiovascular disease was completed at Lankenau Hospital, of Thomas Jefferson University in Philadelphia. Dr. Weinreich is Board Certified by the American Board of Internal Medicine with a subspecialty in cardiovascular disease, Board Certified in Nuclear Cardiology, and is also a Fellow with the American College of Cardiology.


Vassar Brothers Medical Center

Northern Duchess Hospital
The Heart Center
1 Columbia Street
Poughkeepsie, NY 12601
845-473-1188
www.healthquest.org/heartcenter


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