This is my last article dealing with recent advancement in medical tests for heart issues. This one concerns the relatively new Chemical Stress Test (CST).
Most of us who have done stress tests in the past are familiar with the one where the patient is hooked to electrodes and monitored as he or she walks on a treadmill. The walk starts off slowly and gradually builds to a fast pace. Sometimes the treadmill is set to simulate uphill and/or downhill walking in order to gage if the heart reacts any differently under those situations.
While that certainly can be an uncomfortable experience for those who do not walk on a regular basis or those who are significantly out of shape, it in no way compares to the agony of its chemical sister. That particular test borders on medieval torture.
A chemical stress test uses an isotope medication that is inserted into the body via an IV. Its purpose it to take the heart to its highest extremes of stress. This is accomplished by forcing the arteries of the body wide open so that blood is allowed to flow at maximum volume.
The patient is hooked up to an EKG machine during the test so that the heart is monitored at all times. The temporary side effects of the test are severe. Opening the arteries in the manner used ensures certain symptoms, which include, but are not limited to hot flashes, tingling or burning throughout the body, sweats, severe headache, nausea (and possible vomiting).
I personally thought that nothing could hurt as much as a heart attack itself. I was wrong! This test is as severe if not more so. Although it only takes about six minutes, the agony and pain of the test makes it feel more like six months.
The purpose of the CST is to determine how the arteries respond; how well the blood flows through the heart; and whether or not any blockages are encountered in the process. It apparently works well as my physician was satisfied with the results. I, on the other hand, was not since it left me with a raging migraine.
For the most part, physicians still prefer the old-fashioned treadmill test whenever it can be used. However, there are sometimes instances, like mine, when the patient is unable to do the treadmill test. The chemical stress test then becomes an excellent alternative. Situations that may prevent a patient from doing a standard stress test include disability, stroke, back or joint problems, dizziness and/or fainting, inability to hold a steady gait, or shortness of breath.
The test can be performed in-patient or out-patient. However, if it is to be performed out patient, the individual should allow at least four to six hours for the test. The exact timing will be dependent upon whether or not an EchoCardiogram and/or Nuclear Scan has been ordered in conjunction with the chemical stress test. If the doctor is planning to run those tests anyway, he or she will most likely schedule them at the same time so that the patient doesn’t have to go through the same agonizing medication more than once.
In preparation for the test, it is likely that the patient will be asked not to eat or drink between three to six hours prior to the test. Additionally, some heart medications may need to be halted up to three days prior to the test as they could skew the test in the wrong direction or cause the patient additional suffering.
Patients will be required to remove clothing from the waist up and either wear a hospital gown that opens in the front or use a sheet or blanket for modesty purposes. The technicians and physicians must have unobstructed access to the chest area during the test.
The safety of the chemical stress test is still under some consideration. Although the isotope medication used involves only a small amount of radiation, the results of the test itself may prove to be a bigger culprit. In my case, it left me with a migraine.
However, staff is always in attendance during such tests to ensure the safety of the patient.
Some of the other side effects of this test could include new or increased palpitations or even heart attack. However, these are quite rare. The more likely side effects are headache, fatigue, and nausea. In some instances, asthmatics may also experience lung stress due to the test.
The results of the test will generally take a few hours to process, although the physician can generally give the patient an idea of the EKG portion of the test while he or she is still on the table.
There appears to be about equal validity between the regular treadmill and the chemical stress test. Both have around a 10 percent rate of possible error. In my case, my physician was certain the results were accurate since they mirrored those of the other tests performed.
