How to Perform Cardiac Stress Testing & Protocols

The purpose of a cardiac stress test is to study the condition of the heart as it is exposed to exercise versus its normal resting flow. It measures how well the blood flows through the heart's arteries when it is exposed to stress, identifying any problems that might indicate arterial blockage. It can also indicate the potential for heart disease. Various methods exist for conducting a stress test.

Instructions

Stress Test Protocol

• 1

  Give the patient information about the test. Include instructions for fasting and medication suspension. Outline the type of clothing and footwear to be worn. Answer the patient's questions and have him sign the necessary consent forms.

• 2

  Before testing, have the patient remove any necessary clothing. Give him a hospital-style gown turned around to open in the front so that lead attachment can be done easily.

• 3

  Attach lead wires to the chest as needed. Attach blood pressure and oxygen measuring devices as required.

• 4

  Take baseline readings of blood pressure, oxygen and pulse. This will help compare resting rates against stress readings.

Chemical Stress Test

• 5

  Conduct a chemical stress test when the patient cannot do the exercise required. This test simulates exercise through a chemical injected through an IV.

• 6

  Hook up and start a saline IV of solution in the patient's hand or arm. It will be used to transport the chemical needed to complete the test.

• 7

  Inject the chemical into the IV solution started in Step 2. Adenosine, dipyridamole, or dobutamine are the chemicals most likely be used.

• 8

  Continue blood pressure, oxygen and pulse measurements throughout the procedure. Note any symptoms presented by the patient such shortness of breath, chest pain or irregular heartbeat.

Nuclear Stress Test

• 9

  Conduct a nuclear stress test to identify the parts of the heart that are damaged versus those that are healthy. This procedure combines exercise with an injected isotope and imaging.

• 10

  Insert an IV plug into the patient. It will be used to inject the isotope.

• 11

  Begin the treadmill stress test as described below. Approximately 2 minutes before the test ends, inject the isotope into the IV plug and flush with saline to make sure the isotope is distributed evenly.

• 12

  Wait 5 minutes for the isotope to work its way into the heart. Begin imaging prior to that could prove inconclusive.

• 13

  Place the patient into the imaging scanner. Record the images needed.

Stress Echocardiogram

• 14

  Have the patient begin walking a treadmill. Increase speed at increments approximately 3 minutes apart.

• 15

  Make note of blood pressure and oxygen measurements prior to each speed increase. Record symptom information provided by the patient.

• 16

  Stop the test if the patient indicates he's reached his maximum stress level or when ECG readings identify a cardiac problem. Note symptoms like chest pain, dizziness, fatigue, lightheadedness or inability to breathe properly.

• 17

  Continue monitoring the patient until his heart returns to normal. This is gauged through blood pressure, pulse and the ECG baseline.