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Your doctor may recommend a cardiac stress test if you have signs or symptoms of coronary artery disease or an irregular heart rhythm (arrhythmia). Most tests are noninvasive or minimally invasive and can help you learn more about how your heart is working.

Exercise stress test

An exercise stress test, or exercise ECG, is used to determine how well your heart responds during physical activity.

During the test, a technician places electrode patches on your chest that are also attached to an electrocardiogram (ECG) monitor. You walk on a treadmill or pedal an exercise bicycle at varying speeds and with different inclines to add resistance. As you exercise, the electrical signals of your heart are measured with the ECG.

Stress echocardiography

Stress echocardiography is a test that uses ultrasound imaging to show how well your heart muscle is working to pump blood to your body. It is most often used to detect a decrease in blood flow to the heart from narrowing in the coronary arteries.

A resting echocardiogram will be done first. While you lie down, a small device called a transducer is held against your chest to create the images. Afterward, most people will walk on a treadmill or pedal on an exercise bicycle at varying speeds and with different inclines to add resistance.

More echocardiogram images will be taken while your heart rate is increasing, or when it reaches its peak. The images will show whether any parts of the heart muscle do not work as well when your heart rate increases.

Nuclear stress test

A nuclear stress test is an imaging method that uses radioactive material to show how well blood flows into the heart muscle, both at rest and during activity.

During the test, a small amount of a radioactive material is added to the bloodstream with an IV before and during physical exercise on a treadmill. A special camera is used to scan your heart and create pictures to show how the substance has traveled through your blood and into your heart. The before and after images can help your physician determine if you have heart disease or if your heart disease is worsening.

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