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Treadmill Stress Test
A Treadmill Stress Test is a simple test where the patient walks on the treadmill, and the cardiologist assesses the EKG before, during, and after the test for specific abnormalities. The treadmill is started at a relatively slow “warm-up” speed. The treadmill speed and its slope or inclination is increased every three minutes according to a preprogrammed Bruce protocol. The treadmill is stopped when the patient achieves a target heart rate (this is 85% of the maximal heart rate predicted for the patient’s age). The test may be stopped prior to achievement of the target heart rate if the patient develops significant chest discomfort, shortness of breath, dizziness, unsteady gait, etc., or if the EKG shows alarming changes or serious irregular heart beats. It may also be stopped if the blood pressure (BP) rises or falls beyond acceptable limits.
Stress Test is heavily dependent upon interpretation of EKG changes produced by exercise. Therefore, the reliability drops in patients with certain heart conditions, use of medication such as digitalis, high blood pressure, presence of a bundle branch block pattern, etc. In all such cases, the physician will usually order a Nuclear Stress Test, particularly if the patient is being ruled out for Coronary Artery Disease. However, a regular stress test may be sufficient in stable patients with a low suspicion of Coronary Artery Disease.
A Treadmill Stress Test is only about 60-70 percent accurate. Also, false abnormalities often occur, especially in female patients.