When should you have a cardiac stress test?

January 4, 2019 Providence Health Team

Even if you’ve never had one yourself, you are probably familiar with the cardiac stress test, in which a person is hooked up to electrodes and asked to walk or jog on a treadmill under medical supervision. It’s a familiar trope in cinema, in which we see the aspiring athlete/aging astronaut/stressed-out executive put through the paces before the serious conversation with the white-coated medical professional.

That’s a fair representation of what an exercise stress test looks like. Health care providers order such tests to look for weakness or abnormalities in the way the heart pumps under stress.

But it may surprise you to learn that physicians don’t regard the stress test as routine. In fact, most physician groups, from the American College of Cardiology to the Society for Vascular Medicine, advise against giving the test to people who don’t show symptoms of heart problems or are in low heart-risk categories. One of the reasons is that they worry about false positives, which can lead to unnecessary treatment, not to mention undue stress.

“The latest recommendations point out that a careful review of the medical literature failed to find any convincing evidence that resting or exercise ECG provided useful information for preventing CVD events in asymptomatic adults,” states an editorial in the August 2018 edition of JAMA Cardiology.

The stress test has its place

Stress tests are commonly ordered by physicians who want a clearer picture of your heart’s strength. The American Heart Association says the test may be called for when a physician seeks to:

  • Diagnose coronary artery disease
  • Diagnose the causes of chest pain, shortness of breath or lightheadedness
  • Recommend a safe level of exercise
  • Check the effectiveness of procedures done in patients with coronary artery disease
  • Predict the likelihood of risk of a heart attack or other serious heart problems.

So, when is the right time to have an exercise stress test? If you have symptoms of heart problems or have an elevated risk for a serious heart condition and your physician recommends it — that’s when you should have a cardiac stress test.

If you or someone you care about experiences symptoms that could signal heart problems, see your health care provider. You can find a Providence provider in our online directory.

Washington: Providence Heart & VascularProvidence Spokane Heart InstituteSwedish Heart & Vascular InstituteKadlec Regional Medical Center

Oregon: Providence Heart & Vascular Institute

California: Providence Saint John’s Health Center; Providence Little Company of Mary Medical Center Torrance, Providence Saint Joseph Medical Center; St. Joseph Hospital Heart and Vascular Center; St. Jude Medical Center; St. Mary Medical Center - Heart and Vascular Center; Heart Institute at St. Joseph Hospital - Humboldt

Alaska: Providence Heart & Vascular Center

Montana: International Heart Institute

Health Break - Heart disease prevention, from Providence International Heart Institute, MT:

Read more helpful heart and vascular health articles like this one. Subscribe to our blog and you’ll never miss a health update:

More reading

New blood pressure guidelines trigger rethinking of heart risk

How to be heart healthy at any age

Heart attack? It might feel different if you’re a woman

“Cardiac exercise stress testing: What it can and cannot tell you,” by the Harvard Medical School.

“Screening for Cardiovascular Disease Risk with Electrocardiography,” offers the latest recommendation by the U.S. Preventive Services Task Force, published by JAMA in June 2018.

The American Heart Association’s resource page explains the mechanics of the exercise stress test.

This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.

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