During your exercise ECG, the physician will
be looking at a number of factors in order to get an overall picture
of how your heart is functioning. For instance:
• Generally, if you have a healthy
heart and are in good shape, you’ll be able to exercise
longer. Therefore, the physician will be interested in how long
you’re able to maintain certain levels of exercise.
• It’s normal to feel tired
or short of breath with exertion. During the test, you’ll
be monitored to see if you develop
any other symptoms such as excessive shortness of breath
or chest pain that may indicate a heart problem.
• Your heart rate and blood pressure
should rise during exercise. The physician will watch for
changes in your ECG or a fall in your blood pressure that may
indicate that some part of your heart isn’t working properly.
An exercise ECG is especially helpful in diagnosing
blockage in the coronary arteries (blood vessels that carry blood
to the heart). When these arteries are narrowed or blocked, your
heart may not receive enough blood and oxygen. During exercise,
this blood supply may be reduced even further, causing chest pain
or changes in your ECG while you’re undergoing this test.
• not to eat or drink for several
hours prior to the test in order to prevent feeling sick to
your stomach.
• to stop taking certain medications
a day or two before the test to help make the results more accurate.
• to wear loose, comfortable clothing
and walking shoes or sneakers for your test
• to talk about the test —
its purpose, benefits and risks — and ask any questions
you may have.
• to sign a consent form for the
procedure.
If you’re diabetic, you’ll be given
special instructions from your health care provider concerning
eating and taking your medication before your test. To prepare
for your test, your chest will be cleaned (some areas may be shaved)
and a nurse or technician will place several electrodes (small
sticky pads) on your chest and shoulders. These electrodes are
connected by wires to an ECG machine. You’ll also wear a
blood pressure cuff during and after your test. You’ll be
shown how to step on and off the treadmill and how to use the
railings for balance.
Procedure
During the stress ECG, the speed of the treadmill
will start slowly and the incline or slope will be flat. As you
exercise, the speed will be increased and the incline raised gradually.
Be sure to report any symptoms, such as chest pain, shortness
of breath, or dizziness.
The test will end when you become too tired
to continue, you develop ECG changes, you reach your maximum heart
rate, or you develop excessive physical symptoms.
Usually, the test takes 45 minutes to one
hour.
There is a very small amount of risk because
the test is placing stress on the heart. However, serious, life-threatening
complications are rare and the staff is ready and specially trained
to handle any emergency.
To get additional specialized information,
your physician may order an exercise ECG with Cardiolite, a radioactive
material used to help determine if the heart is getting the blood
supply it needs. For this procedure, a small amount of the material
will be injected into an intravenous catheter (IV) in your arm
while you’re at rest and approximately one minute before
you stop exercising. It’s not unusual to experience a metallic
taste in your mouth for a few seconds after the injection.
Approximately 30 minutes after one dose, while
you’re lying flat on a table, a special camera will be placed
close to your chest to take a series of pictures from various
angles. The material clears from your body by natural processes,
and the amount of radiation you’ll be exposed to is similar
to receiving a chest x-ray. Adverse reactions to this radioactive
material are rare. When added to your stress test, this procedure
will take a total of 3 to 4 hours.
If you’re unable to exercise to the level
of exertion needed for the exercise ECG, your
physician may order a Stress Test with IV Persantine (or a similar
drug). This drug is used to simulate (give the same effect as)
the stress caused by exercise. Although Persantine is a safe medication,
there may be some side effects (that can easily be reversed) including
dizziness, chest pressure, shortness of breath, headache, nausea,
and feeling flushed. Be sure to report any of these feelings to
the physician or staff.
Because caffeine can interfere with the effect
of Persantine, you may be asked not to drink anything with caffeine
for up to 12 hours before the test. If you’re taking medication
for asthma, be sure to tell your physician as you may be asked
to stop taking it for a few days before your test. You also may
be asked to avoid other foods and medications, including:
• coffee and tea (even caffeine-free).
• chocolate.
• soda (even caffeine-free and
sugar-free).
• Anacin, Cafergot, Darvon compound,
Excedrin, Fiorinal, NoDoz, and Wigraine.
Note: If you’ll be receiving Persantine,
you won’t need to wear special clothing or shoes for exercising.
To determine how well your heart is pumping,
your physician may order a stress test with a MUGA scan. For this
test, a small amount of radioactive material (not harmful) will
be injected into an IV in your arm. This material makes your blood
visible to a special camera that takes pictures of your heart
as the blood moves in and out. For this procedure, you’ll
be shown how to pedal an exercise bicycle — in an upright
position or lying on your back — instead of walking on a
treadmill. This test usually takes 1 to 2 hours.
Your Recovery
After your test, you’ll be helped to
an area to lie down. While you’re resting, a nurse or technician
will continue to monitor your ECG and blood pressure. Then the
electrodes will be removed and the areas cleaned. Usually, the
physician will give you preliminary results before you leave.
A complete interpretation will take longer. If this test shows
something abnormal, or is not conclusive, your physician may order
additional tests. Because of fatigue, you may want to arrange
to have someone take you home.
Your Good Health
Regardless of the results of your study and
the course of treatment your physician recommends, you play an
important role in staying healthy. Be sure to keep all appointments
for exams and follow-up tests. Follow your instructions, don’t
hesitate to talk about your concerns, and immediately report any
new symptoms.
As always, if you have any questions about
your health, be sure to ask your physician.
If you are a Munson Healthcare patient and have a compliment,
concern, or complaint, please contact one of our Patient
Liaisons.
