5 Things You Should Know About Stress Tests

Your need-to-knows about taking a stress test

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If your doctor has scheduled you for a stress test, it’s helpful to know a few tips before you step on that treadmill.

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Perhaps your doctor wants to figure out if you have coronary artery disease or any abnormal heart rhythms. Maybe there’s a question about whether your cardiac treatment plan is working or your doctor’s trying to design a safe exercise plan for you.

Whatever the case, says cardiologist Benico Barzilai, MD, Head of the Section of Clinical Cardiology at Cleveland Clinic, there are certain things you must know about taking a stress test – other than wearing appropriate clothes and shoes for physical activity.

1. Skip that meal. Don’t eat before you have a stress test. Go into the exercise with an empty stomach.

“There is a difference between completing a stress test on a full stomach versus an empty one,” Dr. Barzilai says. “You can exercise a lot longer and safer if you haven’t eaten.”

If your stress test is first thing in the morning, Dr. Barzilai recommends eating nothing after midnight. If the test is later in the day, don’t eat within four to six hours.

2. Know which pills to take. Make sure you know which medications to take before your stress test. It’s designed to evaluate your heart during exertion, and some medications slow down the heart rate too much.

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Dr. Barzilai frequently tells patients to skip their beta blockers for high blood pressure and congestive heart failure, certain calcium channel blockers that also treat high blood pressure, and nitroglycerin medications that increase blood flow to the heart.

“It’s important for the heart rate to go up during exercise, so patients should consult with their cardiologists about which medications they should avoid taking,” he says. If you use an inhaler, though, you should bring it, he says.

3. Pass on the caffeine. If you’re taking a chemical or nuclear stress test, Dr. Barzilai recommends avoiding caffeine for at least 24 hours before testing.

As a stimulant, caffeine raises your blood pressure and heart rate. It also increases your risk of developing an irregular heartbeat. To bypass the problem, don’t drink coffee or tea, including any decaffeinated beverages, and don’t eat chocolate.

Also, don’t take over-the-counter medications that contain caffeine, such as diet pills or headache medicines, within 24 hours of your test. If you’re not sure if it’s OK to take your medicine, ask your doctor.

4. Exercise beforehand. Daily gym routines aren’t necessary, but you should strive for some activity level before your stress test, Dr. Barzilai says.

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“If patients have been sedentary and not walked around for several months, it won’t work for us to put them through exercise on a treadmill,” he says. “Sometimes it makes sense for them to walk or do something else before they do a stress test.”

5. Manage your diabetes. Before testing, talk with your doctor about your diabetes medications. Don’t take your medicine and skip a meal before the stress test.

If you manage your blood sugar with insulin, your doctor might recommend taking half your usual morning dose and eating a small meal within four hours of testing. Don’t take any pills used to control your blood sugar until after the test.

If you own a glucose monitor, bring it so you can check your blood sugar levels immediately before and after the test. Once the test ends, eat and take your medication.

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