What Types Of Stress Tests Exist, And How Do I Know Which One Is Best For Me?

— -- Question: What types of stress tests exist, and how do I know which one is best for me?

Answer: There are a number of ways to do a stress test. The most common one is to walk on a treadmill because that mimics normal walking. You can do it on a bicycle or you can give medicines which stress the heart by chemical means.

And the choice of the kind of stress test is based upon whether you can exercise or not. And most physicians prefer to have an exercise test over a pharmacological stress test because it's more natural -- it mimics actual circumstances.

In addition to the stress part of it and EKG, the doctors could choose to do what's called an imaging test. And there are several ways of doing that. The most common way is with nuclear, injecting a small amount of nuclear material, which goes where the blood goes in your heart, and taking pictures of your heart both at rest and during stress.

The value of that is that it increases the chance of picking up a problem. And in people whose EKG is not very useful in determining whether there's a problem of the heart, some people, for instance, who have pacemakers, the nuclear test is usually the preferred way to go.

An alternative is to also do an echocardiogram, which is a sound wave of the heart to see how the heart performs during stress. And that also gives the same kind of information. It improves the accuracy of a stress test a little bit and is useful in people in whom you really want to know whether there's any problem at all. In general, most patients who have normal electrocardiograms, a normal treadmill test is perfectly adequate for them.

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