Exercise testing, also called the treadmill test by the most intimate, is an examination performed by some patients to evaluate heart health. It should be performed when directed by a doctor in specific cases or once a year for a complete health check up. It may be accompanied by a baseline electrocardiogram exam, which is performed in the office to check the path of the cardiac electrical activity.
The performance of this test is important because certain problems may be more hidden, being evidenced after a greater physical effort. During and after the exercise test, blood pressure, heart rate and electrical activity are measured during each exercise phase. This way, the doctor can evaluate the performance and health of your heart in the best way.
How is it done?
The ergometric test consists of a light walk on the treadmill that increases the degree of difficulty, being able to reach a heavier run as if it were going up a slope, for example. It can also be performed by bicycle, depending on the office. The test requires disposition and should be performed even by those considered to be sedentary.
The exam can last for up to one hour, counting the preparation, during and after. First, pressure and heart rate are measured, then electrodes attached to an electrocardiogram are placed. The stress test for when the patient reaches 85% of the maximum predicted heart rate for the patient's age.
What is the purpose?
The intent is to investigate the presence of coronary artery obstructions that can lead to acute myocardial infarction, abnormalities in heartbeat that can be diagnosed as arrhythmia, blood pressure changes, and chest pain from physical exertion. If the heart is strong and healthy, you will endure the exercises without much trouble;otherwise, it's good to be aware.
The ergometric test is also used for the functional evaluation of some already diagnosed heart disease and to guide a correct prescription of physical exercises for a given patient.
The patient should wear appropriate clothing for the exam, usually some comfortable clothing that he or she uses to practice physical activities. The patient is also advised not to carry out any kind of heavy effort before the test, so that he does not get tired early and hinder the progress of the exam.
It is also prohibited to smoke cigarettes or to consume caffeine substances two hours before the test. The patient can be fed normally, and the fast is strictly forbidden. Suspension of some medications consumed continuously will be at the discretion of each physician. For better adhesion of the electrodes in the thorax of the man, the ideal is to shave the hairs.
The ergometric test must be performed by a trained cardiologist who can be sure to evaluate the electrocardiographic tracings during the examination without errors. At the end of the examination, a medical report is issued with the variables and impressions properly diagnosed, as well as possible prescriptions of medicines and exercises.
How is maximum heart rate( MHR) obtained?
The FCM is obtained by the formula "220 - the age of the patient".For example, a 40-year-old patient will have an FCM of 180( theoretically), which corresponds to 220-40 = 180 beats per minute. During the exercise test the patient will reach about 153 beats per minute, that is, exactly 85% of the FCM.
- The patient should have a meal two hours before the test;
- Attend an appropriate exercise outfit( shorts, sneakers, fresh blouse, etc.);
- Women should wear bra;
- Men should shave the hairs of the chest;
- Medications of continuous use may or may not be suspended for the exercise test. Note: If suspended, the period of suspension of the medications may vary from 1 to 30 days;
- The presence of a trained physician, appropriate equipment and emergency supplies containing defibrillator in case of cardiorespiratory arrest is essential;
- The equipment used in the examination may be a treadmill or a stationary bicycle;
- Before the examination, a resting electrocardiogram and blood pressure measurement should be performed;
- During the examination the patient's symptoms will be asked, such as fatigue, which should be qualified from 1 to 10, shortness of breath, chest pain, dizziness, leg fatigue, diaphragm pain, feeling faint, among others;
- After the examination is completed within the next five minutes of recovery, new electrocardiographic records and blood pressure measurements are also taken;
- The patient should achieve 85% maximal heart rate( MHR);
- The test may be discontinued depending on the level of physical exhaustion, problems with the electrocardiogram, angina in the chest, excessive elevation of blood pressure, excessive blood pressure drop or other conditions associated with physical exertion.
When and who should perform the exercise test
- May be performed on patients with chest pain or suspected coronary artery disease. The ergometric test presents limitations for the diagnosis of this disease, since the sensitivity and the specificity are inferior to 70% and 80% respectively;
- Risk assessment of future complications in people with known coronary disease;
- After myocardial infarction to evaluate the best conditions of physical activities;
- Diabetic people who wish to start physical activities or have professions that put others at risk;
- Asymptomatic people who want to perform intense activities;
- Asymptomatic individuals who wish to perform physical activities and who have disease risk factors such as smokers, people with cholesterol or a family history of the disease;
- Evaluation of the cardiac conditions of people with diseases of the heart valves;
- Evaluate the conditions of patients undergoing coronary angioplasty or saphenous vein surgery;
- Evaluate patients with arrhythmia, electrical conduction disorders of the heart or who have an artificial pacemaker.
- Exams related to myocardial perfusion scintigraphy, scolygram of stress and ergospirometry.