One of the challenges cardiologists face is how to accurately diagnose symptoms that that you don’t experience all the time. For example, if you feel chest pains, irregular heartbeat, or breathing problems, but these symptoms don’t show up during an electrocardiogram (ECG or EKG) test while you sit quietly in our offices.
At Cross County Cardiology – Mount Sinai, we may recommend a stress test in these cases. We perform this noninvasive test in our office. It measures the electrical activity of your heart while it is “under stress” as you exercise.
Regular Stress Test
During a regular stress test (sometimes called an exercise stress test), we measure your pulse, blood pressure, and your heart’s electrical activity (ECG) while you walk on a treadmill.
The treadmill is pre-programmed so that its speed and degree of incline changes every three minutes, according to a standard protocol. We monitor you the entire time. We may also ask if you have any symptoms such as chest pains, difficulty breathing, or palpitations. If your disease has caused blockages in your arteries, we should be able to tell with this test. While you are exercising, your heart tissue may not get enough blood (become ischemic), which we will be able to see in the ECG results.
We usually schedule stress tests for the morning. We may ask you not to eat or drink before your appointment. You should wear light clothing and comfortable shoes. The test itself is noninvasive. We may apply electrode patches and a blood pressure cuff. The exercise portion of the test usually takes only about ten minutes. However, you may have some preparatory and waiting time, so you should reserve a half an hour for the full test.
Nuclear Stress Test
Cross County Cardiology – Mount Sinai uses the most advanced approaches to diagnosis. If a regular stress test does not give the results we need, we may use a nuclear stress test. This noninvasive procedure integrates electrocardiogram (ECG) monitoring with advanced medical imaging. In this way, a nuclear stress test can detect subtle problems with blood flow.
During a nuclear stress test, the doctor injects you with a small amount of a harmless radioactive substance. Then we use a special camera that tracks the rays emitted by the substance as it flows through the body. This produces a very clear image of the heart. The image helps us identify areas with decreased blood flow, because less of the nuclear marker will appear in those areas.
Doctors often administer a nuclear stress test twice. We may do it once while you are at rest, and then again as you exercise on a treadmill. We compare the two sets of images to see how your blood flows through the heart and nearby coronary arteries.
We may also use a specialized nuclear stress test called a multigated acquisition scan (MUGA). This approach helps us evaluate the pumping function of the ventricles, your heart’s lower chambers.