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A cardiac stress test is a cardiological examination that evaluates the cardiovascular system's response to external stress within a controlled clinical setting. This stress response can be induced through physical exercise (usually a treadmill) or intravenous pharmacological stimulation of heart rate.
The test made extensive use of relatively new technological developments in electrocardiograph machines and motorized treadmills. The Bruce exercise test involved walking on a treadmill while the heart was monitored by an electrocardiograph with various electrodes attached to the body.
Angina index is zero if no pain occurs during the exercise, one if the pain is limited to the exercise period but the patient can continue the exercise (typical angina), and two if a pain is a reason to stop the exercise test. [2] [3] Duke treadmill scores typically range from –25 (highest risk) to +15 (lowest risk).
Rate pressure product is a measure of the stress put on the cardiac muscle based on the number of times it needs to beat per minute (HR) and the arterial blood pressure that it is pumping against (SBP). It will be a direct indication of the energy demand of the heart and thus a good measure of the energy consumption of the heart.
Strain rate imaging during stress has been shown to give incremental value over ordinary echocardiography, both diagnostic [28] [29] and prognostic. [30] In stress echo, the increased heart rate has speckle tracking at a disadvantage, due to the limited frame rate that affects tracking at higher heart rates. [citation needed]
Sonographer doing an echocardiogram of a child Echocardiogram in the parasternal long-axis view, showing a measurement of the heart's left ventricle. Health societies recommend the use of echocardiography for initial diagnosis when a change in the patient's clinical status occurs and when new data from an echocardiogram would result in the physician changing the patient's care. [7]
A transthoracic echocardiogram (TTE) is the most common type of echocardiogram, which is a still or moving image of the internal parts of the heart using ultrasound. In this case, the probe (or ultrasonic transducer ) is placed on the chest or abdomen of the subject to get various views of the heart.
A chest radiograph and routine blood tests may indicate complications or precipitating causes and are often performed upon arrival to an emergency department. New regional wall motion abnormalities on an echocardiogram are also suggestive of a myocardial infarction. Echo may be performed in equivocal cases by the on-call cardiologist. [3]