ErgometryThe treadmill test, also known as test effort, is used to study the functional response of the myocardium (the muscle of the heart) to physical exercise. Thanks to it can be diagnosed accurately situations of ischemia and lack of sufficient areas of myocardial blood flow. Normally this type of ischemia go unnoticed or can give (type angina pectoris) transient chest pain, dyspnoea or arrhythmia. The origin of this lack of blood supply is the presence of cholesterol plaques in the arteries that supply the heart.
The test essentially consists of using special electrodes register the electrical currents that form in the myocardial muscle contractions occur. When performing exercise cells involved in more metabolic activity and, if they do not have a sufficient supply of oxygen, may stop producing these electric currents or altered. The electrodes register is similar to the one of an electrocardiogram, but lasts longer and be seen progressive changes.
The person who is subjected to the stress test must be physical exercise during the test. Similar machines are used to measure the muscular effort that in many gyms. Two are mainly used: the stationary bike or the Ribbon slider to run. Begins with low intensity, and gradually increases to make sure that there is damage to the heart at any time.
It is not a very expensive test, but its interpretation can be difficult sometimes, and must always be accompanied by a good full medical study using clinical interview and physical examination. It must be performed by experts, and only when it will be useful to determine a diagnosis or adjust a treatment. It can be in cardiac units that exist in hospitals and clinics. Doctor who analyzes such tests is the cardiologistand with initial data from the treadmill test can be a quite approximate analysis of the affected area of the heart.
When a stress test is doneThe stress test is useful for detecting heart disturbances. Symptoms that can give heart pathology are mainly two: pain in chest and shortness of breath feeling. The test effort should be when the cardiologist suspects any of the following diseases:
Unexplained chest pain: especially when cardiac features such as feeling of pressure, lack of air, radiates to left shoulder, neck or wrists.
Worsening of angina pectoris: when an angina pectoris is stable there is no worry because you only get pain in situations of known efforts. If this change should be performed a treadmill test to detect changes in the gravity electric log.
After a heart attack: not all attacks it is necessary, but in some cases can help known after the residual damage that has been at the heart and rating other tests.
Study of arrhythmias: certain arrhythmias only appear during physical exertion and exercise testing can help to trigger them and detect them.
Study of valvular heart disease: certain alterations of cardiac valves, especially the stenosis, can cause increase in myocardial unless get you sufficient irrigation. The stress test would detect ischemia unnoticed.
Prevention of ischemic heart disease: adults with cardiovascular risk factors (diabetes, hypertension, high cholesterol, etc.) that have not yet done intense physical exercise ever and that will do it for the first time so intense (e.g., in a gym or a football team) should undergo a stress test that discard unnoticed ischemic alterations.
Preparation for the ergometryIf they are going to perform an stress test or stress test these are issues that you must take into account to be properly prepared to quote:
Duration: exercise testing takes about 20-30 minutes. The only extra time would be the preparation and collection after the test, which in any case would be less than an hour.
Income: ergometry can be performed in a hospital or a health facility without requiring admission, and then you can go back to your normal life.
Is necessary to be accompanied?: is recommended, so you'll be more relaxed.
Drugs: don't need to take any prior medication. You should tell your doctor all the medicines taken regularly and will decide which suspend or maintain, especially if you take drugs for epilepsy, muscle relaxing, antiarrhythmic, or psychiatric diseases. You should not take 48 sexual impotence medications prior to the test (as sildenafil and derivatives).
Food: should stay without smoking and fasting without eating or drinking, the 3-4 hours before the test. If it is too early in the morning consult your doctor if you should take some sugar to avoid a hypoglycemia. 24 hours before the test you can not take caffeine of any origin (coffee, tea, soft drinks, chocolate, energy drinks, etc).
Clothes: you can go to the quote from the test with the same clothes every day; Perhaps you will be asked you here the upper part of the body to place electrodes. It is comfortable, even sports footwear. Breast creams should be avoided to place the electrodes.
Documents: is essential to bring with you the steering wheel which shows the performance of this test. You have to carry the health insurance card and medical history on diseases to study, if you have them, although the doctor will already have this information. It can give you a document after the test.
Pregnancy and breast-feeding: the stress test is not recommended in pregnancy or lactation. It is not a test that is performed much in those situations, since some biological constants are altered for itself during these stages.
Contraindications: not to be able to walk or have some sort of disability prevents the test. Especially weak hearts, with advanced heart failure, must not undergo this test.
How ergometryFirst your doctor will assess if it may be useful to perform a stress test according to the symptoms that present, cardiac auscultation and the tests that you have made previously. If you see fit, I will quote you one day for the test and you will explain the basic measures that you need to know to submit to this. Remember not to take caffeine 24 hours before, and remain in fasting and without smoking four hours prior to the test.
When you get to the room where the test is done ask you discover the upper part of the body to put the electrodes to study. Electrodes that are placed are 10 around the chest, to detect each part of the heart. All electrodes have a cable terminated in a detector that records all the electrical signals, very similar to the electrocardiogram. They also placed you a cuff of the sphygmomanometer to measure you blood pressure and a Pulse Oximeter in any finger to measure blood oxygen level to you.
Once all the electrodes placed you will be prompted that you start to walk or pedal gently. The first few minutes will not do much physical exertion, only will be interested to know whether the registration of the electrodes is correct and meet the morphology of your usual electric log. Every three minutes you will be asked to increase the muscular effort. This can get walking or pedaling faster, increasing the resistance to the movement or tilting the treadmill as if it were a slope. In such a way that every three minutes will increase considerably the physical effort, coming to running and cycling intensity.
Throughout the test the blood pressure monitor cuff swell and compress you arm, you should not worry. Normal is that you sudes, even feel a slight tiredness. There are some symptoms that if they appear you should report to your doctor so that you know it, and assess whether to continue with the test are:
- Pain in the chest.
- Pain in the legs.
- Shortness of breath.
- Dimming of vision.
- Tremor, cold, or nausea.
When you are done the test you must not stop walking for 10 minutes. Thus the heart rate will decrease gradually. Every 15 minutes the nurse will measure you your vital signs and check that all is well. Once you check that all is well removed the electrodes one to one. Then you may have to wait until you give you the results, although not come analyzed by the doctor because you'll need more time.
Complications of ergometryErgometry test is non-invasive and does not usually pose any risk for people who perform it, because for that doctor previously selects suitable people to undergo the test. Some complications that can occur are fainting, severe chest pain, and shortness of breath attacks. It is very strange that you get to produce a full stroke or a malignant arrhythmia, and if it happens, the room will have the means to intervene quickly.
The stress test resultsThroughout the test the different electrodes pick up electrical signals that go to the electrocardiograph and are stored in a memory. At the same time that ergometry is performed these measurements can be observed, but it is difficult to analyse them thoroughly because it takes time and dedication to study the different parameters at the same time. Yes is can detect acute changes that put an end to the test.
The alterations that are sought in the electrocardiogram are typical of cardiac ischemia. These include:
• Peaked T wave.
• Widening of QRS waves.
• ST segment depression (elevation does not usually occur).
When they appear these alterations must relate to the figures of blood pressure, blood oxygen level and the intensity of the exercise carried out at the same time. Thus it will have an overall idea of the heart condition of the patient and the impact that can have on the quality and life expectancy will be valued.
You can go to pick up the results of the stress test to the doctor who sent you the test, and which will normally be a cardiologist. On that date it explain the alterations that have been throughout the study. It may necessary to perform more tests requiring more diagnosis as, for example, a cardiac catheterization. The treatment options will explain you and will recommend you the most suitable option for you.