TREDMILL TEST

It is a cardiac stress test, measuring hearts ability to sustain stress given by exercise in controlled environment.

Why to undergo Treadmill Test?

Mainly used to diagnose Coronary artery disease or determine prognosis after Myocardial infarction (heart attack) or coronary revascularization (angioplasty or bypass surgery).

Who should undergo test?

Patients having

• symptoms suggestive of angina
• history of heart attack
• have undergone angioplasty or bypass surgery.

Which precautions patients should take before undergoing TMT?

• Skip a meal. Water is allowed
• Consult a doctor for BP medicines if any. Some of BP medicines need to be stopped before.
• Avoid caffeine
• Make sure your diabetes is normal
• Practise brisk walking few days prior if you are a health check up case
• If you are taking inhaler for asthma, bring it along with you.

Is fasting needed?

Before doing the test, its preferable not to eat before two hours. Patient can have water if they feel like having.

How much time is needed?

Total time is approximately an hour. Test lasts for 10 to 15 minutes. Preparation takes around 15 minutes.

How do they perform Treadmill Test?

After taking history and checking vitals, chest leads are applied and patient is explained that machine will gradually increase speed and slope every three minutes. For better application of electrodes, shaving may be preferable in chest. Test can be immediately stopped if patient feels so or having chest pain, breathlessness or fatigue. Doctor can also order stopping of test upon finding ECG changes. Most adults achieve target heart rate in 9 minutes.

What does positive and negative test mean?

Positive test means patients ECG is showing changes of angina (lack of adequate blood supply to heart) after workload. It means patient is suffering from ischemic heart disease.

Negative result means even at moderate or high workload, patients heart is having enough blood supply and there is no signs of ischemic heart disease.

What are the risks of this test?

There can be exacerbation of angina, breathlessness, arrhythmia or death. Chances of these complications are 1 %. Test should be carried out in presence of doctor and in set up where iCU and defibrillator facilities are available.

What are chances of false positive or false negative?

Sensitivity of Tredmill test is 73 – 90 % and specificity is 50 – 74 %.

For whom is test contraindicated?

Those having

• Heart attack in last 48 hours
• Uncontrolled BP (more than 200/110 mm hg)
• Unstable angina
• Uncontrolled rhythm disorder of heart
• Severe aortic stenosis, pulmonary embolism
• Acutely ill patient due to any cause
• Advanced COPD.

What is average cost of TMT?

In India, average costing is between 1800 – 2500 Rs. Test is being carried out on OPD basis and needs no hospitalization.