A pulmonary exercise test, also called a pulmonary stress test, can help your doctor assess why you become short of breath. It's used to assess your general physical condition, how your body responds to exercise and how much exercise is safe for you. The test measures your: Heart rate and rhythm.
The exercise part takes only around 15 minutes. It usually involves walking on a treadmill or pedaling a stationary bicycle.
You will be asked to walk on a treadmill for approximately 5 to 15 minutes. The test begins slowly and increases gradually in speed and incline every two to three minutes. During this time, your heart rate, blood pressure and EKG will be monitored.
A treadmill exercise stress test is used to determine the effects of exercise on the heart. Exercise allows doctors to detect abnormal heart rhythms (arrhythmias) and diagnose the presence or absence of coronary artery disease.
But what happens after you fail a stress test? Oftentimes, the next step for people who fail a stress test, and who have risk factors for or symptoms of cardiovascular disease, is an imaging test called a coronary angiography. Your doctor may call it a cardiac catheterization, or “cath” for short.
“Generally a test should last 8 to 12 minutes, unless it is prematurely stopped due to fatigue or abnormal signs/symptoms. Patients who remain on the treadmill for 7 minutes or longer are in good to excellent physical condition.”
The FAA expects testing to achieve 100% of Maximum Predicted Heart Rate (220 minus your age) and nine minutes duration unless medically contraindicated or prevented by symptoms such as fatigue, leg cramps, shortness of breath, or chest discomfort.
Treadmill protocol
In the standard Bruce protocol, the starting point (ie, stage 1) is 1.7 mph at a 10% grade (5 METs). Stage 2 is 2.5 mph at a 12% grade (7 METs). Stage 3 is 3.4 mph at a 14% grade (9 METs). This protocol includes 3-minute periods to allow achievement of a steady state before workload is increased.
Negative result means even at moderate or high workload, patients heart is having enough blood supply and there is no signs of ischemic heart disease.
The difficulty level will increase gradually, with the treadmill tilting up into an incline and the speed increasing to make you walk faster. Your doctor may ask you to breathe into a tube to measure the amount of oxygen you have used.
The exercise stress test involves exercising on a treadmill while you are closely monitored. Yes. However, DO NOT eat or drink anything except water for four hours before the test. Avoid all products that contain caffeine for 24 hours before the test.
After a baseline recording taken at rest, you begin walking on a treadmill at a slow pace (under 2 mph). Every few minutes, the speed and steepness of the treadmill increase, making you work harder. The goal is to exercise until you're too tired or out of breath. But some people stop because of chest or leg pain.
With caveats, the procedure still has a valuable role to play in diagnosing worrisome symptoms like chest pain—especially in older men with risk factors for heart disease. "An exercise stress test is not 100% accurate—no medical test is," Dr. Bhatt says. "But it helps decide what the next step should be."
A regular stress test shows the EKG, heartrate and blood pressure while you are walking on a treadmill. A nuclear stress test shows your physician pictures of the blood flow to the heart muscle, in addition to the EKG, heartrate and blood pressure.
A chemical stress test is used to determine whether or not the heart is getting enough blood flow during exercise. Regular stress tests are generally done on a treadmill. The patient walks on the treadmill and the speed and incline is slowly increased to see how the heart performs as the exercise difficulty increases.
You will be asked to fast (have nothing to eat or drink) after midnight the night before the test. For afternoon appointments you MAY have a light breakfast before 7:30 a.m. Do not smoke or have any caffeine (coffee, tea, decaf, chocolate, tea, soda) 24 hours before the test. Sips of water are okay.
Exercise stress testing should not be performed in patients with symptoms of anemia or severe hepatic, renal or metabolic disorders. A resting ECG is an essential part of the pretest evaluation. The patient should have a resting ECG that is free of the abnormalities listed in Table 4.
The normal ranges of blood pressure response to exercise stress testing are as shown in Figure 1. Normal systolic and diastolic responses to exercise stress testing should not exceed 220 and 100 mm Hg, respectively. Systolic blood pressure of >230 mm Hg is generally considered hazardous.
"It's actually very logical," Hedman said. "When we exercise, the heart needs to pump more blood in each beat and in every minute, which causes systolic blood pressure to increase. The men who were measured with high blood pressure while exercising were in general achieving a higher workload -- they were more fit."
During your cardiac exercise stress test, you'll walk on a treadmill or cycle on an exercise bike until you reach your “target heart rate”- which is 85% of the maximum heart rate predicted for your age.
You are also given medicine (local anesthetic) to numb your throat. This helps you feel more comfortable during the procedure. An exercise stress test measures how your heart deals with the stress of physical activity. You are connected by wires to an ECG monitor.