Types of cardiac exercise tests and their use in diagnosing heart diseases **Exercise test** or **cardiac stress test** is one of the important methods in checking heart function in physical activity conditions. Many **cardiac diseases** do not show any special symptoms at rest, but when they are active, their symptoms appear. For this reason, doctors use **exercise test** to diagnose hidden heart problems. **types of exercise test** ### **1. Standard exercise test (ECG Stress Test)** In this method, the patient walks on a treadmill and gradually the speed and incline of the treadmill increases. At the same time, **heart strip (ECG)**, **blood pressure and heart rate** are checked. **Applications:** - Investigating the presence or severity of coronary artery stenosis - Identification of **cardiac arrhythmia** that occurs during activity - Investigating the ability to tolerate activity in heart patients **Advantages:** - Non-aggressive - Repeatable - Low cost compared to more advanced tests ### **2. exercise test with a stationary bike** Instead of a treadmill, the patient sits on a stationary bike and pedals. This method is suitable for patients who cannot walk on a treadmill for physical reasons (such as orthopedic problems). **Main advantage:** Better control of activity intensity in real time ### **3. Exercise test with nuclear imaging (SPECT or MPI)** In this type of test, a **radioactive** substance (usually technetium or thallium) is injected into the patient. Then **nuclear imaging of the heart** is performed at rest and during activity to identify areas with insufficient blood flow. **Applications:** - Diagnosis of severity and exact location of blockage in coronary arteries - Assessment of the risk of **heart attack** - Checking the effectiveness of treatments or **cardiac surgeries** ### **4. Stress echocardiography (Stress Echo)** In this test, ultrasound images of the heart are taken before and after physical activity. The difference between **the function of the heart walls** in the state of rest and activity helps the doctor to diagnose the failures. **Advantages:** - No radiation - High accuracy in diagnosing heart wall disorders - Suitable for pregnant women or patients sensitive to radiation ### **5. Drug stress test** Some patients are not able to do physical activity. In this case, drugs such as **adenosine**, **dobutamine** or **dipyridamole** are injected to the patient, which cause **increase in heart rate** or vasodilation and create conditions similar to exercise for the heart. Then the function of the heart is checked with ECG, echo or **nuclear imaging**. **Suitable for:** - Elderly patients or those with mobility problems - Those with arthritis, disability or neurological diseases 🎯 Exercise test is recommended for which people? - People with **chest pain suspected of heart** - Those who experience **unexplained shortness of breath** - Patients with a history of heart disease for **evaluation of recovery** - People at high risk such as **diabetics, smokers, or people with high cholesterol** ⚠️ Contraindications for exercise test In some situations, **exercise testing** is prohibited or requires caution, including: - **new heart attack** - **Severe uncontrolled heart failure** - **Dangerous arrhythmias** - **Blood pressure too high or too low** #### Summary **Exercise test** is a very useful tool in examining **heart health** under physical stress conditions. By **checking the heart's response** to exercise or medication, the doctor can make a more accurate decision regarding the continuation of treatment, drug therapy or even the need for **angiography**. Choosing the type of test depends on the patient's physical condition, age, disease history and diagnostic purpose.