So I spent a sleepless night in the ER (which I walked to, as I live across the street from a hospital) and the conclusion is that they wanted to admit me for a stress test. (Which I had to decline, partly because the EKG and blood tests came back good, so there appears to be no imminent danger, if at all)
So…Sunday night I will be admitted for 23 hours or less, and be given a stress test on Monday.
So, for those who may have done a stress test, I’d like to know…
What’s involved?
How long is it?
What should I expect?
What should I bring?
I assume that you’re talking about the test where they hook you up to an EKG and run you on a treadmill. I’ve had a couple of them. It doesn’t really matter what you wear, but I defnitely recommend loose clothing and tennis shoes.
As I said, they hook you up to an EKG, then you stand on a treadmill. It starts at a pretty good loping run and the angle gradully increases. By the end of the test, my face was pretty red, and I was sweating and panting. From what I understand, the maximum time of the test is 12 minutes, but they will decrease the time if your vitals show that you’re maxing out.
Check with your doctor and hospital about how long it takes to check in and all that sort of stuff. For me, the test itself was very simple - just a few minutes of running on a treadmill. The treadmill started out somewhat slower than the fastest I can possibly run, and on a slight incline. It wasn’t easy. But after the first minute or so, the treadmill went faster, and steeply uphill. It was hell. But that’s the whole point – to push you to your limit, and keep you going as long as you possibly can. I pooped out somewhere around 2 1/2 or 3 minutes. And then you sit for a while, recovering from the workout.
I am a type-2 diabetic, not taking insulin. I had never before encountered a low blood sugar situation. A few minutes after the stress test, as I was sitting there, my body doesn’t realize that the test is over, and it starts metabolizing my sugar - which it doesn’t really need to do, because the test is over. Long story short, I felt really weird for a few minutes, and ended up passing out. That’s why these things are done in a hospital. A glass of orange juice and I was okay, but the docs and nurses and techs were pretty pissed that I had not been managing my sugar and didn’t even know what my regular blood sugar numbers are. Learned my lesson but good.
Wear comfortable athletic shoes and loose clothing.
The EKG stress tests I have experienced consisted of laying down on an examining table and having a surprisingly large number of electrode sensors being pasted all over my torso followed by a technician taking a sonogram of my heart which is done by slathering some sort of lubricant on my chest and then moving a sensor to get various recordings of my heart in action “at rest”. This would usually take 10 to 15 minutes and includes some slight discomfort as they press pretty hard into the ribs occassionally.
After they have the sonogram videos and EKG recordings of your heart at rest it’s then time to see how it looks under stress. You will be put on a treadmill which will start at walking speed with a slight incline both of which will be increased each 5 minutes or so until your heart reaches a target (which for me was about 90% max). During this time the EKG readings are monitored by a doctor and you will be asked repeatedly “how are you feeling?” and “any chest pain?”.
Once the target heart rate is reached you are hustled back to the examining table and the sonogram portion is repeated with your heart now pumping like mad. The technician and doctor review the EKG and sonogram recordings.
I am not a doctor but as it was explained to me they are essentially looking for parts of the heart wall which are not contracting fully which could indicate some sort of blockage or damage and reading the EKG which would show irregularities in your heartbeat.
All in all it takes about 45 minutes or so and from what I understand are an effective but not 100% sure way to spot heart issues.
Some stress tests use exercise (treadmill) while others use a chemical like dobutamine to stimulate your heart to race instead. Also, some just use an EKG while others may have an echocardiogram (ultrasound) as well.
Not to scare you, but a good acquaintance had normal EKG & blood tests but a cath showed 90%+ blockage in 5 arteries.
Also (not to scare you) but circa 1997 one of the officers that I worked with showed up late for his shift (very unusual for him). Turns out he had a doctors appointment before work. He looked peaked all day. In the middle of the shift he sat down on a bench and said “fellows, I’m about to make your day real interesting” and had a massive heart attack.
Turned out the doctors appointment was a stress test. A test the cardiologist read as normal.
yep…I know that feeling.
A relative of mine-age 72, had a perfectly healthy and no problems—according to the stress test. Then she collapsed from a heart attack 2 weeks later.
Not to scare you but my friend went in for a stress test about 2 years ago, he was 42 years old, dropped dead of a massive heart attack while on the treadmill, guess if you are going to have a heart attack the best place is the hospital but it didn’t work out for him.
Not to scare you, but my father had a heart attack at 41 (triple bypass+survived, yay) and has had roughly semi-yearly stress tests for the last 20 years and has been fine*.
well fine in that he hasn’t had another heart attack, though there are other issues
These are absolutely questions you should ask your doctor. It’s part of what she’s supposed to tell you to get Informed Consent for the procedure.
Other posters have shared the “how” they do it, so I’ll share the “why”. Basically, they’re looking for what ways, if any, your heart handles blood flow when it’s working hard differently from when it’s not working so hard. So they “look” at it - they give you a radioactive dye in your vein and take an x-ray to see where the dye goes. They do this first while your heart is not working hard. That gives them an idea of how well organized your heart is when you’re just laying around. Then they give you more dye, and get your heart working harder. Sometimes they do this with exercise, and sometimes with drugs that increase your heart rate.
A “chemical” stress test is when they increase your heart rate with drugs because you can’t handle exercise. You will feel a pressure on your chest and a feeling of, as the textbooks call it, “impending doom”. Often patients feel very anxious during this part. You may think you can’t handle it and you’re going to die. Hang in there. It lasts about 15 seconds, and then the medication wears off very, very quickly.
So while an EKG and ultrasound are often done *during *a stress test, they’re not really part of the regular stress test. (If the ultrasound is done it’s called an Echo Stress Test.) The stress test is dye, x-ray, dye, stimulation, x-ray. The dye is injected into your blood and shows up on the x-ray. If a part of your heart isn’t getting blood, either at rest or on exertion, they’ll see it on the x-ray as a dark spot.
The part we weren’t expecting when my SO had his done recently was the waiting. It takes some time for the dye to make it all through the blood, apparently. We weren’t expecting 45 minutes of downtime before the first and between the two x-rays. We didn’t expect the whole thing to take nearly 3 hours! Most of that is waiting. The test part is very brief, just a few minutes.
A simple EKG is really not so much of a predictive test, but rather a test to see if anything has already happened. I know last year of a man who had two simple EKGs that came back fine. Then they did a stress EKG and he had blockages and had to have angioplasty and a stint put in.
A little background…I’m from a large family and I have 2 older brothers. Both of them had big heart attacks at 41 YOA. One survived. One didn’t.
After the second I went to my family doctor (and I never see doctors) and said “heart disease doesn’t run in my family.” He laughed and said, “It does now.” That was 10ish years ago.
Fast forward to last weekend. I was having chest pains for a long time that night. (3+hours) And… my brothers experiences are not far from me. I was encouraged to go to the ER. (fwiw, my brothers are/were heavy smokers and practicing alcoholics. I am neither)
My EKG and blood tests were okeedokey. (and my blood pressure is always 120/80) They wanted to admit me and conduct a stress test Monday morning. As I appeared not to be in imminent danger I declined, suggesting I would schedule the test in the next week or so.
So I am looking forward to the test, because I feel-----and have felt for 10 years-----that my brothers heart attacks have been silently stalking me.
There are good reason for and against taking a stress test.
If you are retired and are relatively inactive I would not take one. As others have posted, People do die on or shortly after stress tests.
If you are still expecting to work and or live an active life, like I am planning an Elk hunt this fall, a stress test would be advisable following your symptoms and HX.
From your original post;
The blood tests do need time to rule out heart damage.
You walked across the street;
I can understand your independence, however with symptoms like you describe I would not allow a Pt. to get up from a chair and walk to my ambulance stretcher unless it was upsetting to said Pt.
We have a clinic 300 ft from the emergency department in a nearby town. When someone presents symptoms similar to yours the clinic will call for the local ALS Ambulance service to transport that Pt. the 300 ft. across street to the ER at a cost in excess of $1200.00 :eek:
I think that qualifies as a stress test:D