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False positives due to higher sensitivity/ diaphragmatic attenuation.False negatives in single vessel/circumflex territory ischaemia (increased sensitivity with cycle ergometry).Assessment of exercise capacity, cardiac structure/function.Lowest sensitivity of all stress tests: risk of false negative test.First line test in absence of contraindications.
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Cardiac stress test cost, performance, advantages and disadvantages 1,3,5,6 There are advantages and limitations to each of the different testing modalities for the evaluation of myocardial ischaemia ( Table 1). chronotropic incompetence), as well as risk assessment in the postinfarct, preoperative or high risk patient populations. Other indications include work-up for potential cardiac causes of dyspnoea (noting dyspnoea can be a cardiac equivalent symptom of CAD), and evaluation of the effects of exercise on valvular dysfunction, pulmonary pressures or arrhythmia (eg. The annual risk of cardiovascular mortality can be quantified from stress test results by measures such as the Duke treadmill score (low risk equating to 5% per year cardiovascular mortality). The main reason for cardiac stress testing is the risk stratification of known or possible CAD. When should cardiac stress testing be ordered? A detailed discussion of other tests for the noninvasive assessment of CAD, such as nuclear stress testing or computerised tomography (CT) coronary angiography, is beyond the scope of this article. 1,2Ĭardiac stress testing includes stress electrocardiography (ECG) – also known as exercise stress test (EST) – and stress echocardiography. Cardiac stress testing is useful in the risk stratification of chest pain noting that 15–39% of angiograms performed are normal. Coronary angiography is the gold standard for identifying CAD, although it is invasive and not without risk of complication.
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For SPECT exams, wear comfortable clothes and rubber-soled shoes or sneakers for the treadmill portion of this exam.If you have diabetes, please speak to your physician prior to this exam to receive special instructions you may need regarding your medications.If you are undergoing this type of an exam, you may take all your heart and blood pressure medications as instructed by your physician. If you are unable to exercise on the treadmill, a medication will be administered to stress your heart.Do not eat or drink for three hours before your appointment.Consult your physician about going off beta blockers for 48 hours and calcium channel blockers 24 hours before your exam.Note: Decaffeinated products contain caffeine. Do not eat or drink caffeine products (chocolate, soda, tea, coffee or Excedrin®) for 24 hours before exam.
#Reference tool for cardiac stress test registration
You can print and fill out the Cardiac Imaging Questionnaire, before arriving to speed the registration process.