Stress Test Without Exercising?

Dr. Harlan Krumholz answers the question: 'Stress Test Without Exercising?'

— -- Question: What if I can't exercise? How can a stress test be done without exercising?

Answer: Some people who are recommended for stress tests actually can't exercise. As these tests were first developed, they were developed so that people could get on a treadmill, or actually some people would get on a bicycle or actually use with their arms what we would call 'arm regometry,' they would move a bicycle wheel with their arms. The whole point was to see how people exercised, and we used that information to understand their level of risk, we used that information to diagnose whether there was a problem with their heart.

Now, increasingly, in our population, especially with older individuals, there are many individuals who can't exercise. There's a lot of people who can't get on a treadmill, which is our most common way to provide the exercise. Well, remarkably over the past 20 to 30 years, we've developed strategies, methods where we can essentially provide the same test and get the same information just by injecting some drugs. And those drugs can provide us the opportunity to watch the heart function and to determine someone's risk.

Now these most commonly use imaging, so that when we're injecting people with something, or we're using an echocardiogram and injecting something, we're taking pictures of the heart and watching it.

But that's the basic way that we get around it, is if they can't exercise, and we would prefer you to exercise if you can, we have a variety of other ways using drugs to stress the heart essentially and to be able to make the same sort of determinations we do as if you were exercising.

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