Knowing how to prepare and what to expect can help you feel more comfortable about your heart test.
If your provider has recommended a cardiac stress test, you may wonder what the test involves or whether you will need to walk on a treadmill.
A cardiac stress test helps your care team learn how your heart works during physical activity. Some tests use medicine instead of exercise. Depending on the test, your team may also take pictures to see how your heart pumps or how blood flows to your heart muscle.
At Madison County Health Care System, we offer treadmill stress tests, stress echocardiograms, and nuclear stress tests. Your provider will choose the test that best fits your needs.
How you prepare depends on which test you are having. Review the instructions you receive when your test is scheduled. If those directions are different from the information below, follow the instructions from your healthcare team.
Treadmill Stress Test (TMST)
A treadmill stress test checks how your heart responds to exercise. While you walk, your care team watches how fast and how regularly your heart beats. They also check your blood pressure and ask how you are feeling.
How to Prepare
- Wear comfortable clothes and walking shoes. Choose clothes that let you move easily.
- Do not eat for at least 2 hours before your test. You may drink water, and drinking water is encouraged.
- Follow your medicine instructions. Some medicines can affect the test. Do not stop taking a prescribed medicine unless your healthcare provider tells you to.
- Avoid caffeine if your care team tells you to. Coffee, tea, and other drinks with caffeine can affect some stress tests. Follow the directions for your test.
What to Expect
Small, sticky patches on your chest connect to a machine called an EKG or ECG. This machine tracks your heartbeat. A cuff on your arm checks your blood pressure. You will start by walking slowly on a treadmill. The treadmill will gradually get faster and tilt upward, making the walk more challenging. Your care team will watch your heartbeat, blood pressure, and how your body responds to exercise. Tell them if you have any discomfort or feel unwell.
The test can be stopped if you become too tired to continue or your care team notices symptoms or changes that need attention.
Stress Echocardiogram
A stress echocardiogram, also called a stress echo, combines a stress test with ultrasound pictures of your heart. Ultrasound uses sound waves to make moving pictures. These pictures help your care team see how well your heart pumps when it is working harder.
How to Prepare
- Wear comfortable clothes and walking shoes. Choose clothes that let you move easily.
- Do not eat for at least 2 hours before your test. You may drink water, and drinking water is encouraged.
- Follow your medicine instructions. Some medicines can affect the test. Do not stop taking a prescribed medicine unless your healthcare provider tells you to.
- Avoid caffeine if your care team tells you to. Coffee, tea, and other drinks with caffeine can affect some stress tests. Follow the directions for your test.
- You may be asked to remove clothing from the waist up and wear a gown. This allows your care team to take ultrasound pictures and place the sticky patches that track your heartbeat.
What to Expect
Your care team will take ultrasound pictures of your heart while you rest and again when your heart is working harder. If your test includes exercise, you will walk on a treadmill that gradually becomes more challenging. Your care team will watch your heartbeat and check your blood pressure throughout the exercise portion of your test.
The pictures help your provider compare how your heart pumps at rest and with activity.
Nuclear Stress Test: Myocardial Perfusion Imaging (MPI)
A nuclear stress test shows how well blood flows to your heart muscle. Its medical name is myocardial perfusion imaging, or MPI.
This test uses a small amount of a radioactive substance, called a tracer, and a special camera to take pictures of your heart.
How to Prepare
- Avoid caffeine for at least 12 hours before your test. Do not have regular or decaffeinated coffee, tea, soda, energy drinks, chocolate, or other products containing caffeine.
- Do not eat for 4 hours before your test. You may drink water during this time and up until your test.
- Follow your medicine instructions. Some medicines can affect the test. Do not stop taking a prescribed medicine unless your healthcare provider tells you to.
- Wear comfortable clothes and shoes suitable for exercise if your test includes walking on a treadmill.
- Tell your care team before the test if you are pregnant or could be pregnant.
What to Expect
The tracer is given through a small tube called an IV, placed in a vein. A special camera then takes pictures that show blood flow to different areas of your heart muscle. Pictures are taken to compare blood flow while your heart is at rest and during the stress portion of the test. An EKG or ECG machine tracks your heartbeat during the stress portion.
You may walk on a treadmill for this test. If you cannot exercise enough for the test, your care team may use medicine instead. Depending on the medicine, it changes blood flow to your heart or makes your heart work harder.
An Important Reminder About Medicines
Do not stop taking any medicine unless your healthcare provider has specifically told you to do so.
Some medicines can affect your stress test. Follow the medicine instructions you receive when your test is scheduled. If you are unsure which medicines to take, call your care team before your appointment.
Questions Before Your Test?
You do not have to figure out the preparation steps on your own. Check out our full list of Frequently Asked Questions about Cardiac Stress Tests.
If you have additional questions about eating, drinking, caffeine, medicines, or any other instructions, call Cardiac Testing at 515-462-5206 before your appointment.
Trusted Cardiac Stress Testing Resources
The following resources provide additional general information about cardiac stress tests. They should not replace recommendations or preparation instructions provided by your healthcare team.
MedlinePlus | Stress Tests
Patient-friendly information from the National Library of Medicine about different types of stress tests, why they are ordered, how to prepare, and what results may mean.
MedlinePlus | Stress Echocardiography
Information about stress echocardiograms, including how ultrasound pictures help show how your heart works during exercise and what to expect during the test.
American Heart Association | Myocardial Perfusion Imaging
Information about nuclear heart imaging, including how it checks blood flow to your heart muscle and how exercise or medicine may be used during testing.
Mayo Clinic | Stress Test
An overview of cardiac stress testing, including why it may be recommended, possible risks, preparation, and what happens before, during, and after the test.