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Today a strange thing happened. I was standing on the road and suddenly everything got black. I felt dizzy. Then everything cleared but my heart rate has increased very much. I went to eat biryani and reached home almost after an hour (I was with my friends). Still my heart was pounding. After I woke up from a sound sleep than I felt good. What had actually happened?
A Stress test is done by making you do exercises like walking on a treadmill or riding a stationary bike during an Electro Cardiogram or ECG. Sometimes, medication to stimulate your heart is used instead of exercise.
The stress test compares the circulation of blood in the heart when you are resting and when you are under optimum physical pressure. There are various types of stress tests, but the most common of them is the Treadmill Stress Test or TMT.
Why it’s done?
- A stress test is a common test for identifying a heart problem like Coronary Artery Disease or CAD in which the major blood vessels that supply your heart with blood, oxygen and nutrients, also called coronary arteries, get blocked, damaged or diseased.
- It’s also used for determining the condition of your heart after a heart attack.
- TMT utilizes exercise so it helps to show up extreme shortness in breathing, chest discomfort, dizziness and sudden weakness- all of these indicating an underlying heart condition.
- TMT is also used to check the efficiency of the heart medications for diseases like angina and ischemia and to monitor heart function in patients who’ve had an angioplasty or a heart attack earlier.
- It is also to identify an abnormal heart rhythm due to exercise.
CAD and Diabetes
People with diabetes are at high risk of coronary artery disease, as it tends to present late, Diabetics also suffer more silent heart muscle problems like Ischemia. This is why TMT is a lifesaver for diabetics as early detection and intervention can save lives.
- You need to prepare yourself before you take a stress test.
- You must not eat or drink anything but water for four hours before the exercise stress test which includes TMT.
- You should not drink any beverage with caffeine for twelve hours before the test too.
- You must stop all medications for the heart on the day the test is scheduled, unless specifically instructed by your doctor.
- If you are a diabetic, you should ask your doctor how much insulin can you inject on the day of the test, and if you are on pills, be aware that the medication is only to be taken after the completion of the stress test.
- You should wear comfortable clothes and soft walking shoes or sneakers for the TMT.
How is a TMT done?
A nurse or technician will place electrodes on your chest. These are then attached to wires that carry the electrical activity of your heart to the monitor and recorder of the ECG/EKG machine. These leads record different parts of your heart.
- Before you start the test, the EKG will record your heart activity on paper. This is called the Resting EKG.
- Initially, the treadmill is switched on at a rather slow ‘warm-up’ speed and gradually both the incline of the treadmill and the speed is increased every three minutes called stages.
- During TMT your blood pressure is recorded at the second minute in every stage.
- A stress test generally takes up to 90 minutes from beginning to end, but the exercise part of the test takes only 20 minutes.
- If you develop any uneasiness, TMT is stopped before the target heart rate is achieved.
How TMT Works
During the TMT, the healthy arteries in the heart dilate more than the blocked ones. This uneven dilation means that more blood is provided to the heart by the healthy arteries as compared to the blocked ones to their designated areas. This lowered blood flow makes the muscles in those areas thirsty for more blood during the TMT, creating symptoms like chest pain, and/or shortness of breath. If you wish to discuss about any specific problem, you can consult an Endocrinologist.