EKG and Stress Testing

EKG and Stress Testing Staff

An electrocardiogram (EKG, ECG) is a test that measures the electrical signals that control the rhythm of your heartbeat.

The Cardiovascular Center is equipped with a state-of-the-art, wireless EKG system and an array of cardiac stress-testing equipment. This equipment allows our staff to perform the exams efficiently and quickly.  Our physicians have access to the information anytime, anywhere, via our Cardiovascular Information System for interpretation so the results get to your physician quickly.

The Cardiovascular Center has three stress-testing labs where our cardiologists work with our technologists, nurses and radiologists to quickly and accurately diagnose heart disease.

Types of Services provided

Electrocardiograms (EKG)

An EKG is a quick and painless test that provides the physician with valuable information about the health of the heart.

Holter Analysis

Holter monitors can be worn on an outpatient basis
and will record 24 hours of EKG tracing.

Exercise Stress Testing

Under controlled conditions, exercise is used to assess the heart’s ability to function under a burden.

Nuclear Stress Testing

Adding nuclear imaging before and after stress testing can increase the sensitivity and accuracy of the test.

What Patients Should Know

• Patients can pre-register for their outpatient testing by calling 781-624-4090.
• Questions are welcome! Please call 781-624-8307 during weekdays with any questions
  or concerns about your test.

What is a Stress Test?

Exercise stress testing is an invaluable tool for examining the cardiovascular (i.e., the heart and blood vessels) system's response to exercise. It provides important diagnostic and prognostic information that cardiologists and radiologists use to evaluate and manage patients with heart disease. When performed by trained physicians in appropriately selected patients, exercise stress testing is a safe procedure that poses minimal risks and can provide a wealth of information.

Who needs a Stress Test?

Although there are many reasons for your doctor to order a stress test, the most common reason is to evaluate the cause of chest pain. Because chest pain can come from areas other than the heart, such as the esophagus or the chest wall, a stress test can be helpful in determining the likelihood of whether or not you have heart disease. Sometimes a physician may ask you to have a stress test in the absence of chest pain if he or she suspects you are at increased risk of having coronary artery disease (also referred to as atherosclerosis or hardening of the arteries). Stress tests can also aid in the diagnosis and management of arrhythmias, which are abnormal and potentially harmful heart rhythms.

How a Stress Test works

Following a brief physical exam, you will be connected to an electrocardiogram (EKG) so that your heart rate and rhythm can be monitored throughout your exercise and recovery (rest period).  The test begins at a slow pace and is designed to make the heart work progressively harder by gradually increasing the speed and the incline of the treadmill. A physician and a nurse or trained assistant will be with you throughout the test. After you have finished exercising, you will be asked to lie down for several minutes. Once your heart rate returns to its baseline, the test is concluded.

Other types of Stress Tests

Stress testing is frequently combined with either echocardiography (cardiac ultrasound) or nuclear scanning (exercise thallium). Exercise thallium testing involves the injection of a
safe and small amount of radioactive medication into a vein before and during exercise.
This medication is then absorbed by the heart muscle except in areas that are problematic
or have been scarred by a heart attack. A special camera is used to image the heart muscle and requires you to lie under it for several minutes before and after you exercise.

Inability to exercise

Many patients are not able to exercise vigorously enough due to other underlying medical conditions. These conditions may include peripheral vascular disease, arthritis of the knees or hips, severe emphysema, or a previous stroke that impairs their ability to walk. In spite of these limitations, stress testing can still be performed using an infusion of medicine in place of exercise (pharmacologic stress testing). Pharmacologic stress testing involves the intravenous administration of medicines that cause the arteries of the heart to dilate (get bigger) as they would during exercise.

How to prepare for a Stress Test

Relax. Get a good night's sleep. There are no complicated preparations for the test, but there are a few things you should remember:

• Avoid eating anything on the morning of your test.

• It's OK to take your medications with some water, but check with your doctor first to see which of your medicines you should or should not take before the test.

• Do not drink any coffee (including decaf), tea or colas, especially if you will be having a pharmacologic stress test, as caffeine may inhibit the effects of the intravenous medications.

• Remember to bring rubber-soled shoes (e.g., jogging shoes or tennis shoes) and wear comfortable, loose-fitting clothes. You may also want to bring a towel to use after you exercise.

• If you experience chest pain, have trouble breathing, or simply don't feel well, please inform your doctor before getting on the treadmill.

• If you experience pain or have trouble breathing at any time during your test please inform the nurse or technician immediately.