Heart and Vascular
Stress Testing
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Stress tests are a noninvasive technique commonly used to evaluate the flow of blood to your heart muscle. They can identify areas of the heart muscle that have an inadequate blood supply as well as the areas of heart muscle that are scarred from a previous heart attack.

The tests also can evaluate the pumping function of the heart. Some patients may need an additional level of testing using an imaging agent. These tests are often called nuclear cardiology tests.

Nuclear medicine tests help identify patients at increased risk for a heart attack and those who may be candidates for procedures such as coronary angiography, angioplasty and heart surgery. While tests are usually done while the patient is exercising on a treadmill or stationery bike, some patients who can’t exercise may be given a "chemical" stress test using a drug that simulates exercise.

Who should get a stress test?

A physician may recommend an exercise stress test:

  • To diagnose the cause of symptoms such as chest pain, shortness of breath or lightheadedness
  • To determine a safe level of exercise
  • To check the effectiveness of procedures done to improve coronary artery circulation in patients with coronary artery disease
  • To predict risk of dangerous heart-related conditions such as a heart attack
  • To diagnose coronary artery disease

Before the test, the patient is connected to equipment which will monitor the heart. The patient then walks slowly on a motorized treadmill. The speed is slowly increased and the treadmill is tilted to produce the effect of going uphill.

What does a stress test monitor?

Stress test patients are monitored for:

  • Heart rate
  • Breathing rate
  • Blood pressure
  • How tired they feel

Patients can stop the test at any time if needed. Medical professionals are present throughout the test.

Sinai-Grace stress testing types

At DMC Sinai-Grace Hospital, several types of stress tests and nuclear cardiology tests are performed:

  • Exercise Stress Test (GXT): The patient is monitored by EKG and blood pressures are taken before, during and after the test. The test is symptom limited. Average time on the treadmill is six to 12 minutes. The entire test takes 30 minutes.
  • Exercise Stress Echocardiogram: Before and after the treadmill test, echocardiogram pictures are taken. This compares the wall motion of the heart at rest and when it becomes stressed. Average time on the treadmill is six to 12 minutes. The entire test takes 45 minutes.
  • Dobutamine Stress Echocardiogram: During the treadmill test, the patient is given the medication Dobutamine intravenously. The medication slowly increases the heart rate and contractility until the desired heart rate is obtained or the patient’s symptoms limit the study. Echocardiograms are taken before, during and after the Dobutamine infusion. The test takes approximately one hour.
  • Exercise Sestamibi (Stress Cardiolite): Prior to exercise, a Cardiolite injection is given and resting images taken of the cardiac structure. When a predetermined heart rate has been achieved during the stress test, a second injection of Cardiolite is given. After a rest period, a set of images of the heart is taken. The entire test lasts approximately three hours.
  • Persantine Sestamibi (Persantine Cardiolite): Prior to exercise, a Cardiolite injection is given and resting images taken of the cardiac structure. The patient also receives Persantine intravenously, then a second injection of Cardiolite. After a rest period, a set of images of the heart is taken. The entire test lasts approximately three hours.
  • Dobutamine Sestamibi (Dobutamine Cardiolite): Prior to exercise, a Cardiolite injection is given and resting images taken of the cardiac structure. During the treadmill test, the patient is given the medication Dobutamine intravenously. The medication will slowly increase the heart rate and contractility until the desired heart rate is obtained or the patient’s symptoms limit the study. A second injection of Cardiolite is administered. Echocardiograms are taken before, during and after the test. The test takes approximately three and a half hours.

Preparing for an exercise stress test

Your cardiologist will determine if you need an exercise stress test. Once you have been provided a referral from your physician, you may call the Cardiology Department at DMC Sinai-Grace and schedule an appointment that fits your schedule. A team member will provide all information necessary to schedule the test, necessary preparations and location. To schedule an exercise stress test, call 313-966-4488.


For more information about DMC Sinai-Grace Hospital’s cardiology services or a referral to a Sinai-Grace cardiologist, call 313-966-4800.