Definition

  Tests used to provoke myocardial ischemia by stressing (increasing the demands from) the heart are called exercise tests (stress tests).



Exercise and coronary blood flow

  In a healthy adult, the coronary blood flow may increase up to 6 times during exercise.

  Increased coronary blood flow is necessary to supply the increased oxygen needs of heart during exercise, which will in turn result in increased cardiac output to supply the increased demands of skeletal muscle. This will result in continuation of exercise.

  In patients with subtotal coronary artery stenosis, the resting coronary blood flow is usually sufficient to supply the reduced oxygen needs of heart. However, during exercise the coronary artery stenosis does not let coronary blood flow to increase. This will prevent the increase of cardiac output and exercise cannot be maintained.

  Exercise-induced ischemia will result in complaints of angina pectoris and/or dyspnea on exertion and the patient is forced to stop the exercise.



Purpose of treadmill exercise test

  To diagnose coronary artery disease.

  To measure exercise capacity and to estimate prognosis.

  To evaluate for exercise-induced arrhythmias.



Exercise methods used to stress the heart

  Treadmill (most common)

  Bicycle ergometry

  Arm crank ergometry

  6-minute walking test

  Hand dynamometer (as static exercise)