If your doctor recommends one of these routine exams, here's what you can expect.

By Jenn Sinrich
February 12, 2021
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If you are experiencing any symptoms that could be related to a heart condition, such as chest pain, irregular heartbeat, or shortness of breath, your doctor may recommend that a stress test be performed. And while it might sound scary at first, stress tests are quite common—and one of the most effective ways to determine the health of your heart. "A stress test looks for evidence of heart disease by determining how hard the heart has to work during exercise," explains Alexandra Lajoie, MD, a non-invasive cardiologist at Providence Saint John's Health Center in Santa Monica, California. "It is performed while a patient is exercising, either on a treadmill or stationary bike, or through the use of medicines that act like exercise on the heart, to determine if someone's electrical system is healthy or starting to fail."

ECG Stress Test Graph
Credit: Getty Images

A doctor may order a stress test for a patient if they are exhibiting any signs associated with coronary artery disease or heart rhythm disorders. "Candidacy increases if these patients are over the age of 40 with a family history of cardiac disease—or have other medical conditions like diabetes, hypertension, or high cholesterol," notes Amanda Donohue, MD, a cardiologist and internist at MemorialCare Heart & Vascular Institute at Orange Coast Medical Center in Fountain Valley, California. And while this exam is routine, there are a few important facts doctors think are worth knowing beforehand—discover them ahead.

You might get a little sweaty.

If you are slated to perform this test on an exercise bike or treadmill, expect to get a little sweaty, like you would if you were exercising at home or at the gym, notes Dr. Donohue. "For a treadmill stress test, expect to have some stickers placed on your chest to monitor your heart rate and heart rhythm," she says. "Dress like you are going for a quick, but brisk jog."

You may also have an ultrasound performed on your heart.

Stress echocardiograms are another type of stress test may be performed before and after the exercise portion of this exam. "The echocardiogram gives us direct visualization of the cardiac chambers, which gives us an indirect assessment of the coronary arteries," says Dr. Donohue.

If you can't exercise, you will be given medicine, instead.

Should you be unable to use these machines, you will be given a nuclear or dobutamine stress test, which helps mimic exercise. "In general, physical exercise is preferred, but these two medications offer a great alternative for those who cannot safely exercise," continues Dr. Donohue. "They are usually administered in the presence of a physician or nurse practitioner and often used in patients with stability issues or orthopedic limitations."

An abnormal stress test can predict coronary artery disease.

If your stress test is abnormal, coronary artery disease may be to blame. This, Dr. Donohue explains, is when the blood vessels that supply your heart with much-needed oxygenated blood become clogged with cholesterol and plaque. A stress test can also help diagnose heart rhythm issues. "Heart arrhythmias occur when the electrical impulses in your heart start to act too fast, too slow or irregular," Dr. Donohue says. "In addition, a stress test can help determine the timing of different surgeries, such as valve replacement and cardiac transplantation."

A normal stress test can indicate other issues.

And if your stress test is normal, but you've consistently experienced discomfort in your chest? Non-cardiac causes of pain, such as musculoskeletal pain, should be evaluated accordingly, says Dr. Lavoie, adding that they are useful, nonetheless. "Stress tests are also useful to determine someone's exercise capacity, which is an indicator of overall health and a good predictor of how well a patient's heart will handle surgery and certain cancer therapies," she notes.

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