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Exercise Stress Test

A stress test, sometimes called a treadmill test or exercise test, helps a doctor find out how well your heart copes with an increase in demand. As your body works harder during the test, it requires more oxygen, so the heart must pump more blood. The test can show if the blood supply is reduced in the arteries that supply the heart. Heart rate, breathing, blood pressure, electrocardiogram (ECG), and general fatigue levels are all monitored during the test.

Preparation:

  • Fast for 4 hours
  • You will need to wear closed in shoes suitable for treadmill exercise and comfortable clothing (a loose short-sleeved shirt and shorts or trousers).

Test Duration: 1 hour (includes waiting at the end of the test for the doctors report).

Are there any after effects: No

Clinical Indications:

  • Diagnose Coronary Artery Disease
  • Diagnose a possible heart-related cause of symptoms such as chest pain, shortness of breath or lightheadedness
  • Employment/Recreational assessments, eg. pilots, divers, mine workers etc.

Exercise Room

Holter Monitor

A holter monitor is a battery operated portable device that measures and records heart activity (ECG) continuously for 24 hours. 5 Electrodes (small patches) are stuck on your chest, these are attached by 5 wires to a small recording monitor that can be worn around your neck or tucked into a pocket.

Preparation:

  • Please shower before you arrive as you cannot shower over the 24hr period, the monitor cannot get wet.

Test Duration: 15 minutes to set up and explain the procedure, and then the next day 5 minutes to remove device.

  • You will be asked to fill out a diary documenting any symptoms and activities that you do over the 24 hours so that the reporting doctor can match them with your Holter monitor findings.

Clinical Indications:

  • Bone pain
  • Fractures
  • Osteomyelitis
  • Arthritis
  • Paget’s Disease
  • Bone Metastases
  • Complex Regional Pain Syndrome
  • Avascular Necrosis
  • Joint replacement loosening or infection

Holter Monitor

Myocardial Perfusion Scan

This test is used to evaluate the blood supply (perfusion) to the heart. Imaging of the blood supply to your heart is acquired before and after a stress test. The stress test is either an exercise stress test on a treadmill, or if treadmill exercise cannot be achieved, a medication to mimic exercise will be used. In order to obtain images of the heart, an injection of a radioactive material (radiopharmaceutical) is required into a vein in the arm.

Test Duration: 3.5 hours – bring a good book.

Are there any after effects: No

Clinical Indications:

  • Diagnose Coronary Artery Disease
  • To assess a patient’s heart function before major surgery
  • Determination of viability of heart muscle after a previous or recent heart attack.
  • To predict the risk of a heart attack.
  • Assess blood flow to the heart following stent or bypass

Preparation:

  • Fast for 4 hours before the test
  • No caffeinated substances including coffee, tea, chocolate and soft drink for 24 hours prior to the procedure
  • Please confirm this appointment as soon as possible as alterations to medications may be required.
  • You will need to wear closed in shoes suitable for treadmill exercise and comfortable clothing (a loose short-sleeved shirt and shorts or trousers)

These two images depicts a normal scan. As you can see the blood flow to the heart is similar on the stress images (top row) and rest images (bottom row).

Click on images to enlarge

These two images show an abnormal perfusion scan which demonstrates ischaemia (an inadequate blood supply) in the side wall of the heart.

Gated Heart Pool Scan

This test measures how well your heart is pumping.

The test involves an injection into a vein in the arm, then wait for 20 minutes and receive another injection and commence scanning immediately which is usually for approximately 25 minutes.

Preparation: Nil
Test Duration: 1 hour
Are there any after effects: No

Clinical Indications:

  • Measure the performance of the heart, ie. Ejection Fraction (EF – measurement of the percentage of blood leaving your heart each time it contracts)
  • Monitor the effects of chemotherapy on the heart

Click to enlarge

The above result is from a patient undergoing chemotherapy, that can affect heart function. This scan was required to determine her heart function between treatments.