A chemical stress test is used to see how much stress a heart can take. Historically stress tests were done using exercise like running on a treadmill for a certain period of time. Chemical stress tests are relatively new clinical tests to estimate heart function under outside stress circumstances.
The chemicals used are Isotope meds like dobutamine, dipyridamole or adenosine that is delivered through an IV. The chemical causes the arteries in your heart to dilate which puts the heart under stress. When the arteries dilate the blood flows through quicker which causes the heart to beat faster.
The entire process may take only about 6 minutes. During the stress test the patient is hooked up to an EKG machine to monitor their heart rate. The results are evaluated and it is determined how well the heart can handle the stress. The results can be a good predictor of an impending heart attack.
There are special steps that have to be taken with this type of test that include eliminating certain types of medication before the test time. This test also requires that food and liquids are avoided for up to 6 hours before the test time. A health care professional can go over the details of what has to be done prior to and after the testing to insure a successful testing session.
There are some clinicians that feel that the best type of stress test is the good old fashioned treadmill testing while others feel that the chemical stress test is advantageous because it is does not rely on patient’s ability or performance on the treadmill. It relies on the absolute reaction of the medication and the effects of the stress on the heart.
List of Pros of Chemical Stress Test
1. Incapable Patient
In some cases the traditional method of stress testing is not really an option. For some people getting on a treadmill and pushing themselves is just not possible. For example if someone has limb issues or breathing problems pushing themselves on the treadmill. Chemical stress testing is the only answer for people that cannot for whatever reason get on the treadmill.
2. It is Easier
A chemical stress test is actually easier to take. You do not have to run on the treadmill and push yourself. You just sit with an IV and let the tests run. It is a simpler way to take the test. Of course it is also easier on your joints and muscles.
3. Shorter Time
The chemical stress test is typical a shorter test than the traditional treadmill test. While the set up make take a bit longer the actual testing time is shorter. You will spend less time overall with this type of test.
List of Cons of Chemical Stress Test
1. Heart Attack
The biggest con of this type of test can be very high. It can result in a sudden heart attack. Although having a heart attack during the test is very rare it is still possible. Technicians closely monitor patients while they are being tested.
2. Chest Pain
Chest pain is not exclusive to this test it can happen with either type of the stress test. The chest pain can be an indicator that the heart is under stress and it is completely normal during this type of test however there are some indications that the chest pain can be more severe with this type of test because the stress is induced unnaturally.
3. Increased Anxiety
For many people the idea of being pumped with chemicals to stress their heart is a huge stressor. The heightened anxiety about the test can actual skew the test results to make them seem like your heart is in worse condition than it really is. The fear of the test alone can be enough to elevate the negative response of the testing and give a false report.
4. Unnatural Method
The goal of the chemical stress test is to mimic what would normally happen to your heart during exercise. Some opponents to this kind of testing believe that the unnatural nature of the testing is not actually a good or realistic measure of the actual stress that naturally occurs in the heart. Some opponents of this type of testing believe that this test puts more strain on the heart than is necessary.
5. Irregular Heartbeat
There is a stronger possibility with this type of stress test that you will develop an irregular heartbeat during the testing and for some time after the test. It is largely through to be a side effect of the chemicals and while they have a short shelf life they can have lasting effects. The effects can last for up to two weeks.
6. Longer Prep Time
It will take you longer to get ready to take this type of test. There will be medications that you cannot take when you get ready to take this test. The test itself will be shorter but overall the experience will likely be a longer period of time. The time period can vary from one hour or more.
7. The Cost
The chemical stress test can be more expensive than the traditional treadmill test because you have the added expense of the medications and the cost of the IV and other incidental costs that you do not have with the traditional treadmill test. The difference in cost can range from a few hundred to a few thousand dollars. Most insurance companies will cover the majority of the testing costs. Speaking to an insurance representative can shed some light on the cost difference.
Your doctor will be the best judge of which stress test is right for you. They both offer a way to test your heart and to ultimately help you to get the health care that you need. In most cases your cardiologist will make the decision as to which test is best for your situation but you can discuss which test you prefer to try to sway the decision.
Chemical stress testing may be the only type of test that is available to you because of other health conditions. If you have joint concerns, asthma, COPD or other breathing issues than this may be the only way to stress your heart safely.
Other conditions that may leave chemical testing as the only viable testing method include being grossly overweight to where it impedes your ability to move, wheelchair bound or any other condition that keeps you from getting on a treadmill and being able to run up to 15 minutes at varying speeds and inclines.
There are risks but with constant monitoring the risks are rarely fatal. In many cases gaining the knowledge is well worth the risks. This type of testing can help to ensure heart health and help to offset a potentially fatal cardiac event.