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Pharmacologic Stress Test

When a stress test is recommended to assess your heart’s function, it may not always be possible for a patient to exercise. If you have physical limitations like back trouble, joint disease, marked fatigue, unsteady gait, prior stroke, dizziness, shortness of breath, or other medical conditions and just cannot exercise enough to undergo the traditional exercise tolerance test, a pharmacologic stress test is an excellent option. Medication serves the purpose of increasing the heart load instead of using exercise, which in conjunction with nuclear imaging is used to identify blockages in your heart arteries, heart blood vessels, or bypasses that could lead to a heart attack or cause chest pain.

How does a Pharmacologic Stress Test work? Is it safe?

There are two methods commonly used in pharmacologic stress tests.

In one, the medications used — such as dobutamine, which acts like adrenaline and is sometimes combined with atropine — increase the amount of work your heart does. Nuclear imaging is then used to monitor your heart in conjunction with this medication.

The second method involves the medications dipyridamole or adenosine, which cause the coronary arteries to widen and produce a dramatic increase in blood flow. Blood flow does not increase in blocked arteries, which can't widen. Nuclear imaging is then used to detect blockages revealed by these medications.

Pharmacologic stress tests aren't for everyone. People with asthma, emphysema, carotid artery disease, or aortic stenosis should not take dipyridamole or adenosine. Anyone with uncontrolled hypertension or abnormal heart rhythms should not take dobutamine. However, for many people, pharmacologic stress testing is a safe and effective test to assess your heart health.