A stress test is a functional test of the heart. The patient uses a treadmill or stationary bike to exercise, causing progressive fatigue of the heart and an increase in heart rate. This allows the doctor to assess whether the heart can cope under conditions of maximum demand.
How is the exercise test performed?
Once the patient gets on the treadmill or stationary bike, the doctor will connect the electrocardiogram (ECG). This records the heart’s electrical impulses. The doctor also measures blood pressure and monitors for symptoms such as chest discomfort (angina) or fatigue. As the patient exercises, the doctor monitors the patient’s heart function as well as any symptoms that may arise. Abnormalities in blood pressure, heart rhythm on the ECG, or a worsening of symptoms may indicate coronary artery disease (CAD).
Is it reliable?
The stress test is not 100% accurate. It does not accurately detect all cases of coronary artery disease, and sometimes it may indicate a suspicion of the disease in people who do not actually have it.
At the clinics CarE MediC clinics, you can undergo a stress test on either a treadmill or a stationary bike using digital technology, with results provided electronically.
What does the stress test show?
The fatigue test can be interpreted in three ways:
- Positive stress test: The patient is at high risk for coronary artery disease.
- Inconsistent stress test: The patient exhibits certain symptoms, but the test results appear normal.
- Negative stress test: The patient has a low risk of coronary artery disease.
Positive fatigue test
A positive exercise stress test usually includes symptoms such as pain, chest tightness, and unexplained difficulty breathing (shortness of breath) following strenuous exertion (activity or work). Patients who experience these symptoms are at high risk for coronary artery disease. When these symptoms are accompanied by risk factors such as advanced age, obesity, high cholesterol, diabetes, and smoking, then a positive exercise test indicates an even higher likelihood of severe CHD, and further evaluation is warranted.
Exercise stress test for suspected coronary artery disease
If the patient has symptoms but the test results appear normal, the risk of SN is lower. However, the doctor may need to perform further tests to rule it out.
Negative fatigue test
If there are no symptoms and the test results appear normal, the risk of CAD is even lower. However, it is important to understand that a normal stress test cannot rule out the possibility that an atherosclerotic plaque will rupture (atherosclerotic plaque rupture) later and block the artery. The test identifies arteries that are severely narrowed (70% or more). These are the ones that cause symptoms. Heart attacks, however, are often caused by smaller narrowings that break off and form blood clots.
Exercise Test: Limitations of the Test
A stress test is an important tool for diagnosing coronary artery disease, but it is not foolproof. The diagnosis is not based solely on a single test, but on a combination of factors.
The accuracy of the test depends on whether the patient exercises sufficiently on the treadmill or stationary bike, as well as on the increase in heart rate achieved. During the test, blood pressure and the heart’s electrical activity are closely monitored. If the patient is unable to reach the required level of exertion, the The findings may not fully reflect the functional status of his coronary arteries.
In addition, taking certain medications or having other heart conditions may affect the interpretation of the results. For this reason, the result is always evaluated in conjunction with the patient’s medical history and risk factors.
Predictive Value of the Exercise Test
The test lasts about 15 minutes, during which time the patient is subjected to progressively increasing exertion. Changes in blood pressure, heart rate, and overall exercise tolerance are recorded.
These data are not limited to the diagnosis of coronary artery disease. They can also assess the future risk of serious events, such as myocardial infarction. In asymptomatic individuals over the age of 40, particularly those who belong to For high-riskgroups, the exercise test is also used as a tool for a comprehensive cardiac evaluation.
When physical activity is not possible
Not all examinees are able to complete a physical exercise test. In such cases, the patient undergoes an alternative procedure.
Medication is used to induce a controlled increase in heart rate, simulating the conditions of fatigue without physical exertion. During the test, the doctor continues to monitor the blood pressure and an electrocardiogram, just as in a standard exercise test.
For patients with a history of myocardial infarction or other heart conditions, the doctor may turn to more specialized techniques. The decision is based on the findings from the examination, the patient’s medical history, and the purpose of the test.
For a reliable and comprehensive cardiological evaluation, please contact the Cardiovascular Department at the CarE MediC clinics in central Athens. The Cardiologist Dr. Christos Maniotis, Ph.D. from the Medical School of the National and Kapodistrian University of Athens, specializing in modern techniques of transthoracic and transesophageal echocardiography and holding European certification (EACVI accreditation), as well as a master’s degree in Ergospirometry, Exercise and Rehabilitation, combines clinical experience, research activity, and international recognition in interventional cardiology.
With many years of training in Greece and the U.S., collaborations with the “Ygeia” and “Mitera” hospitals, and active participation in international multicenter studies, he offers a modern and evidence-based approach to the full spectrum of cardiovascular diseases. Contact the clinics CarE MediC to schedule your examination and receive high-quality, personalized cardiological care.