2024-01-11 17:58:00
Stress test of the heart…pathological and non-pathological reasons for performing it
The Exercise Stress Test is one of the relatively simple heart tests, compared to other heart tests, which has high diagnostic and therapeutic value.
This test is done by stressing the heart through exercise, usually by walking or jogging on a treadmill or using a stationary bike. Through this physical stress on the body as a whole, the heart is “forced” to pump blood with greater force, and to pump blood at a higher pace and acceleration, compared to the normal performance of the heart when the person is still and comfortable or practicing light daily physical activities.
Stress test
This test therefore helps determine the extent of the response of a person’s heart and blood vessels during times when the heart and blood vessels must work at their maximum capacity. To meet the needs of the flow of oxygenated blood to the muscles so that they can work at their maximum capacity, as well as to the lungs so that they purify the blood from carbon dioxide and supply it with oxygen.
During this practical test, the heart’s activity is monitored by connecting it to an ECG device. This is to track the rate at which the expected increase in heart rate continues, to track any changes in the heart rhythm, and the extent to which abnormal “abnormal” pulses appear. And also; To track any changes that may occur in the electrocardiogram, which, if they occur, may reflect the presence of pathological disorders in the coronary arteries. Also during this test, the amount of blood pressure is monitored; To observe the extent of the development of the expected increase in it, or the occurrence of any unexpected decreases, which may indicate problems in the coronary arteries. Also, oxygen levels in the blood are monitored, as an indication of the efficiency of the lungs and the work of the arteries.
The doctor communicates with the patient during this test to follow up on any symptoms he may be complaining of, such as chest pain, the degree of obstruction of gasping and shortness of breath, or pain in the knees, back, or feet. The patient’s ability to continue and continue progressing through the stages of this test. Thus, assessing his body’s response and physical fitness capabilities to bear the burden of physical stress, compared to others of the same age and of the same gender.
Results and diagnosis
And so; Performing a cardiac stress test is a very common test, so that the doctor can clarify:
– The extent of a person’s ability to perform physical activity, compared to other people of his age and of the same gender.
– How well the heart pumps blood.
– Whether during this stress the heart receives adequate blood supply through the coronary arteries.
– Find out whether the symptoms that the person complains of (chest pain, shortness of breath, feeling of rapid heartbeat, and dizziness) can recur during physical activity.
Therefore, this makes it easier to identify and evaluate some of the heart problems a person may have, such as:
– Decreased muscle capacity or problems with the efficiency of the heart valves.
– Lack of sufficient blood flow to the heart muscle, through the coronary arteries.
– The level of electrical stability of the heartbeat during rest and during physical stress.
In addition to the important information mentioned above, the patient and doctor benefit from the cardiac stress test in determining whether the person needs additional cardiac examinations, which are “interventional” cardiac examinations using different types of colored dyes. This is what the doctor usually does not perform except when necessary.
To clarify, the “necessity” is created either by the severity and clarity of the link between the symptoms that the patient complains of and a high-probability heart condition, or by the fact that the results of “non-interventional” cardiac examinations, such as a cardiac stress test, indicate that these possibilities are high, and thus the necessity of performing interventional cardiac examinations. , such as catheterization, to provide certainty regarding the health of the heart, and to confirm a diagnosis or whether treatment may reduce the risk of a heart attack and make a person feel better.
In addition to these direct medical indications, people who work in high-risk professions (such as pilots or professional athletes) may also need tests to evaluate the heart’s endurance capabilities, the ability to maintain cardiac efficiency, electrical stability of the heart, control of high blood pressure, and maintaining normal levels of oxygen in the heart. Blood, all when you are in conditions that are very stressful for the heart.
Test subjects
In these aspects, cardiologists at the Mayo Clinic explain in their answer to the question: “Who should undergo a heart stress test?”, saying in summary: “This test may be appropriate for you if you suffer from symptoms of heart disease, such as:
– Angina, which is pain or discomfort in the chest due to poor blood flow to the heart.
– Arrhythmia, which is a rapid or irregular heartbeat.
– Shortness of breath (if varying degrees of physical exertion are exerted).
– Feeling dizzy or dizzy.
Stress tests are also intended for people with diagnosed heart conditions if:
– Desire to start exercising.
– Undergoing treatment because health care providers need to determine the success of the diagnosis.
– Facing a higher risk of complications due to a personal or family history of heart disease.
In addition, a heart stress test is performed to evaluate your risk of heart disease and heart attacks if you have no known heart disease or symptoms, but you have other risk factors, such as diabetes, high blood pressure, high cholesterol, or a family history of heart disease. Early.
– Or your health condition requires you to undergo surgery (on a part of the body other than the heart), and health care providers need to evaluate (the extent of the possibilities) for the risk of cardiac complications during that surgery or during the recovery period following it.”
What are the different types of cardiac stress tests?
Cardiologists at the Cleveland Clinic say that there are many ways to evaluate heart function during strenuous physical work, in which the heart, lungs, and arteries in the body are stressed to work at the maximum capacity a person can.
The basis is that all cardiac stress tests include monitoring the heart rate, blood pressure measurements, blood oxygen levels, electrical activity within the heart, and the symptoms that may appear on the patient during the examination.
But there are some differences between these types of cardiac stress tests. Types of stress tests include:
• Physical movement stress test. This is the most common and basic cardiac stress test. It involves walking on an electric pedal machine or riding a stationary bike. It is usually performed by a doctor and a well-trained technician. During the testing phases, the speed of the treadmill and the degree of height of the board on which the person runs are increased, according to the patient’s ability to walk and his general physical fitness. What is important is that the burden on the heart is increased, forcing it to beat faster and request more blood to feed it through the coronary arteries.
If a person is unable to perform these physical movements, for reasons related to the joints, for example, he can be given types of medications that make his heart pump stronger and pulse faster, or other types of medications that work to expand the coronary arteries that supply the heart itself with blood. Then a continuous electrocardiogram is performed (following the shape of the electrical activity of the heart), in addition to the vital indicators mentioned in the text of the article.
Ultrasound cardiac stress test. This is another, and accurate, way to follow what the heart muscle and valves do when exerting physical effort, or when the patient is given types of medications that make his heart pump stronger and beat faster. This precise monitoring of the heart is done through continuous ultrasound imaging of the heart (echo), before and during the heart is exposed to these conditions (exercise or receiving these medications).
With this “live imaging,” the doctor has more details, as clearer information is obtained regarding the functions and mechanism of blood flow through the heart valves (which are located between the heart chambers). In addition, careful tracking of the mechanism of contraction of the parts of the heart muscle in the left ventricle, which reflects the safety of the coronary arteries from any narrowings or blockages.
3. Nuclear cardiac stress test. In a nuclear cardiac stress test, “safe” levels of radioactive material are used, cardiac imaging tests are performed, and those images are evaluated.
Mayo Clinic doctors explain: “The nuclear stress test is an imaging test that reveals the nature of blood flow to the heart during rest and exercise. This test uses a small amount of a radioactive substance called a radioactive tracer. This substance is infused through a vein. The imaging device takes pictures of the movement of the tracer through the heart’s arteries. The doctor compares the two sets of images taken during the nuclear stress test. These images reveal the state of blood flow through the heart at rest and during physical activity. The results can show the following:
– Blood flow normally during exercise and rest. In this case, you may not need to perform any other tests.
– Blood flow normally during rest, but not during exercise. Part of the heart does not get enough blood during exercise. This may mean that there is a blockage in one or more of the arteries, or what is known as coronary artery disease.
– Poor blood flow during rest and during exercise. Part of the heart doesn’t get enough blood all the time. This may be due to severe coronary artery disease or a previous heart attack.
– Lack of blood flow in parts of the heart. The parts of the heart where the radioactive tracer is not visible are damaged from a previous heart attack.
This test helps determine the extent of the response of the heart and its blood vessels to meet the body’s needs during stress
Contraindications for cardiac stress tests
If there are no contraindications, cardiac stress tests are often safe. During the examination, both a cardiologist and a specialized technician are present.
However, cardiac stress testing is not for people with heart conditions that make stress testing unsafe. These cases include:
– The presence of dissection in the walls of the aorta.
– The presence of endocarditis (inflammation of the heart valves), pericarditis (inflammation of the outer membrane of the heart) or myocarditis.
– The patient recently suffered a heart attack.
– The presence of severe stenosis of the aortic valve.
– The presence of an uncontrolled arrhythmia.
– The patient complains of constant chest pain.
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