DEAR MAYO CLINIC: I have a treadmill stress test scheduled to look for heart disease. I know this involves exercising, and I’m worried that I’m not physically up to it. Is there another way to gather this information?
ANSWER: Yes. There’s another way to conduct a heart stress test that doesn’t involve exercise. Several drugs can be safely used to mimic the effects of exercise or stress on the heart. This is known as a pharmacological stress imaging study. However, pharmacological stress testing usually is used only when an exercise stress test can’t be performed due to exercise-limiting problems, such as musculoskeletal problems or poor lung function, and in instances when the resting electrocardiogram (ECG) has certain baseline abnormalities or is considered to be non-diagnostic.
A treadmill stress test provides information about your heart function during exercise. Because exercise makes your heart pump harder and faster and more vigorously than it does during most daily activities, the test may be able to reveal problems within your heart that might not be noticeable otherwise.
If you can walk for more than five minutes on flat ground or up one to two flights of stairs without needing to stop, you can most likely exercise enough to participate in a treadmill stress test.
An exercise stress test is preferable to one using drugs. Compared with a pharmacological stress imaging study, an exercise ECG stress test:
In addition, the drugs given to mimic exercise or stress can have side effects of their own.
If the treadmill is a barrier — perhaps because of balance issues or knee arthritis — then other forms of exercise often can be substituted. Exercise bikes are often available as alternatives to the treadmill. (adapted from Mayo Clinic Health Letter) — Dr. J. Wells Askew III, Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota