Austin Regional Clinic offers non-surgical cardiology services, including stress tests. Housing cardiologists with other specialists and primary care physicians at ARC facilities helps patients receive the benefits of a coordinated team approach to health care.

Heart disease can mimic and aggravate other conditions; therefore, having same-office access to a cardiologist can speed diagnosis and close treatment gaps. Other benefits for patients with complex needs may include faster interventions, and fewer repetitive diagnostic tests such as labs and X-rays.
If your physician has suggested that you receive a stress test, Austin Regional Clinic offers stress testing at ARC Far West Medical Tower

What is a Stress Test

We offer three basic types of stress testing: exercise stress tests, nuclear stress tests, and stress echocardiograms. An exercise stress test involves walking on a treadmill or riding a stationary bike while your heart rhythm, blood pressure, and breathing are monitored. A nuclear stress test and a stress echocardiogram both include exercise stress test, with the added component of heart imaging.

You may hear stress tests referred to by different names, such as exercise stress test, treadmill test, stress EKG, stress ECG, nuclear stress test, and stress echocardiogram.

Why Get a Stress Test

Your doctor may recommend a stress test if you have signs or symptoms of coronary artery disease, or for other reasons, such as to guide treatment decisions, measure the effectiveness of treatment or determine the severity if you've already been diagnosed with a heart condition.

Symptoms of coronary artery disease may include:

• Angina, a type of chest pain or discomfort
• Shortness of breath
• Rapid heartbeat
• Irregular heartbeat (arrhythmia)

Other reasons to check your heart health may include if you:

• Are planning to start an exercise program
• Have had recent heart surgery
• Are being treated for heart disease
• Have had a heart attack in the past
• Are at a higher risk for heart disease due to health problems such as diabetes, family history of heart disease, and/or previous heart problems

What to Expect During a Stress Test

The amount of time the test takes is dependent on the type of test you are receiving. In general, the exercise stress test will take about an hour.

• A health care provider will place several electrodes (small sensors that stick to the skin) on your arms, legs, and chest
• The electrodes are attached by wires to an electrocardiogram (EKG) machine, which records your heart's electrical activity
• Are being treated for heart disease
• Have had a heart attack in the past
• You will then walk on a treadmill, starting slowly and then gradually increasing in pace, resistance, and incline until you reach your target heart rate set and/or reach your maximum exercise tolerance as determined by our staff who are supervising the test.

Both nuclear stress tests and stress echocardiograms are imaging tests. That means that pictures will be taken of your heart during testing.

Stress Echocardiogram

• Resting images using an ultrasound machine are acquired at before walking on the treadmill.
• After these images are taken, you will exercise on a treadmill or bicycle, to your maxium effort or target heart rate. When this occurs, you will quickly transfer to the imaging bed so more images can be acquired at peak heart rates.
• The images acquired at rest and exercise are processed and reviewed by your cardiologist.

Nuclear Stress Test

• A health care provider will insert an intravenous (IV) line into your arm that contains a radioactive dye. The dye makes it possible for the health care provider to view images of your heart. It takes between 15–40 minutes for the heart to absorb the dye.
• You will then sit upright in a chair with a camera which will take images of your heart at rest.
• The rest of the test is just like an exercise stress test. You'll be hooked up to an EKG machine, then walk on a treadmill
• When your heart is working at its hardest, you'll get another injection of the radioactive dye, again waiting 15-40 minutes for your heart to absorb the dye.
• You will then be placed back on the chair with the camera which will acquire more images of your heart at high heart rates.
• After these images a processed which takes at least one day, a cardiologist will compare the two sets of images.

Note: The radioactive dye will naturally leave your body through your urine. Drinking lots of water will help remove it faster.

Preparing for the Stress Test

Prior to your stress test, you will receive preparation instructions.

• Food: You may be asked not to eat, drink or smoke for a period of time before a stress test. You may need to avoid caffeine the day before and the day of a nuclear stress test (only).

• Medication: Your doctor will let you know if it's safe for you to continue taking all of your prescription and over-the-counter medications before the test; some may interfere with certain stress tests.If you use an inhaler for asthma or other breathing problems, bring it to the test. Make sure your doctor and the health care team member monitoring your stress test know that you use an inhaler.

• Clothing: Wear or bring comfortable clothes and walking shoes. If you're having a nuclear stress test, don't apply oil, lotion or cream to your skin that day.

Stress Test Risks

A stress test is generally safe, and complications are rare. But, as with any medical procedure, there is a risk of complications, including:

• Low blood pressure. Blood pressure may drop during or immediately after exercise, possibly causing you to feel dizzy or faint. The problem should go away after you stop exercising.
• Abnormal heart rhythms (arrhythmias). Arrhythmias brought on by an exercise stress test usually go away soon after you stop exercising.
• Heart attack (myocardial infarction). Although exceedingly rare, it's possible that an exercise stress test could cause a heart attack.
• Allergic reaction. In rare cases, the radioactive dye used in a nuclear stress test may cause an allergic reaction. Also, a nuclear stress test is not recommended for pregnant women, as the dye might be harmful to an unborn baby.

You will be monitored closely throughout the test to reduce your risk of complications or to quickly treat any health problems.

Results

A normal test result means no blood flow problems were found. If your test result was not normal, it can mean there is reduced blood flow to your heart.

If you had a plain exercise stress test without imaging and your results were not normal, your health care provider may order a nuclear stress test or a stress echocardiogram. These tests are more accurate than exercise stress tests, but also more expensive. If these imaging tests show a problem with your heart,your provider will refer you to a cardiologist if you are not already under the care of one.

Providers

At ARC, our cardiology team works in close collaboration with your primary care physicians. As we use the same EMR system, communication is quick and you will often see our cardiologist the same day or within the week if your test is abnormal. Procedure scheduling, follow-up and details are made easy by our coordinated care philosophy.