Coronary Heart Disease Diagnosis: What To Expect From The Exercise (Cardiac) Stress Test

Coronary heart disease can be fatal, so it is important to diagnose the disease as quickly as possible. Fortunately, several medical tests can help a doctor diagnose the condition. One such test is known as the cardiac stress test, which can provide valuable insights into whether you are a risk factor for heart disease. While the results may not be a 100 percent accurate, it can help the doctor decide the next steps.

What exactly is a stress test?

Essentially, doctors will look for abnormalities in:

• Blood pressure
• Heart rate
• ECG
• Physical symptoms

What can a cardiac stress test tell me?

A cardiac stress test can help:

1. Diagnose heart disease. Specifically, undergoing a cardiac stress test can help diagnose whether you have coronary artery disease (in which the coronary blood vessels that supply your heart muscle with oxygenated blood get blocked) and arrhythmias (in which your heart beats too quickly or too slowly). For men who undergo the stress test and experience chest pain or unexplainable shortness of breath, there is a high likelihood of coronary artery disease. This particularly true if they have risk factors such as being older, being overweight and having high cholesterol.
2. Decide next steps and guide treatment. If you already have a diagnosis of heart disease, conducting a stress test can help determine if your treatment is working well. If it is working well, you should be able to exercise for longer than before. Additionally, it can be used by doctors to help devise a treatment plan by determining the amount of exercise your heart is able to handle. For example, cardiac stress tests can help doctors figure out if a patient needs a heart transplant or another significant surgery.
3. Decide the timing for your cardiac surgery. Doctors often use cardiac stress tests to help figure out the timing for different types of cardiac surgery, such as a valve replacement.

Are cardiac stress tests accurate?

Unfortunately, like all medical tests, results from a cardiac test are not a 100 percent accurate.

Since stress tests are only able to detect arteries that are severely narrowed with a blockage of 70 percent or more, there is a high chance that the test can miss some of the less-blocked arteries. It is often these exact arteries that can rupture and cause a heart attack.

Thus, you can obtain good results from a cardiac stress test and still have coronary artery disease. On the other hand, results may indicate that you do have coronary artery disease when you don’t. Essentially, if results from your cardiac stress test point to coronary artery disease then chances are that you have it. However, due to its high false negative and false positive rates, it is never used as a sole test to diagnose the disease. Instead, the cardiac stress test is used as an add-on to other more sensitive and specific tests. Therefore, even if you have normal results from a stress test, doctors cannot rule out the chance that you may still have coronary artery disease or a fatty deposit that can rupture and block the artery.

So, when should I go get a stress test?

According to current guidelines for preventing heart disease, experts recommend that people don’t go for cardiac stress tests regularly, which was the norm back in the day for older men. In fact, doctors now recommend that patients only do a cardiac stress test if they have symptoms and risk factors that are indicative for coronary artery disease.

What do the results of a stress test look like?

These are the following results you can get from a stress test and what it means:

• Normal result. This means that you do not have arteries that are blocked 70% of more. Thus, you likely don’t have coronary artery disease. However, it doesn’t mean that you won’t have a heart attack. You may still have a heart attack if one of the smaller blockages ruptures. Therefore, even if you get a normal result, you doctor may still ask you to do additional tests.
• Abnormal result. This means that you have arteries that are blocked 70% or more, and thus, likely have coronary artery disease. This abnormal result, while it may be a false alarm, would require you to do further testing in order to confirm that you actually have the disease.