Treadmill stress test gets to the 'heart' of the matter

Staff reporter

Imagine a test that can be conducted — right here in Marion — that can determine if you are at risk for a heart attack.

Imagine a test that can be conducted — right here in Marion — that can determine if you have coronary artery disease.

Imagine no more. It's here — and it's been here for many years. But now it's even better.

St. Luke Hospital of Marion recently purchased a new treadmill which is used for stress testing of patients' hearts.

This new treadmill automatically monitors the patient's blood pressure, is hooked up to the Internet so results can be immediately sent to cardiologists or doctors at local clinics, and can have specific protocol programmed by the operator.

"One of the wonderful features of this treadmill is it's simplicity," chief nursing officer Linda Kannady said.

The treadmill has a computer that troubleshoots. If a "lead" or electrode that is attached to the patient's chest, shoulders, and hips comes loose, the computer alerts the nurse so it can be re-applied. The electrodes monitor the patient's heart during the test.

"It's a great screening tool," Kannady said, "particularly for diagnosing people with heart disease."

Heart disease is the leading cause of death for most middle-aged and older Americans.

The test is ordered for patients with symptoms of heart problems, diabetes, high cholesterol, or a family history of heart problems.

"A lot of people have the test without any symptoms to establish a baseline," Kannady said.

That baseline then is used as a comparison when the treadmill stress test is conducted again at a later date.

The test tracks electrical currents through the heart to make sure the heart is beating normally.

Most of the time, when a doctor orders the test, a medication of Cardiololite is injected through an IV site.

According to radiology manager Joe Pickett, prior to the treadmill test, a scan is made with the hospital's nuclear medicine machine of the heart at rest with the medicine. The Cardiololite travels through the patient's arteries and collects in the heart muscle.

With the hospital's dual head nuclear medicine machine, the technician is able to scan the heart in 15 minutes instead of 30 to 45 minutes which is the case with other forms of scanners.

"The resolution also is 30 percent better with this machine," Pickett said, which is superior quality to other equipment in the area.

The patient then takes a treadmill stress test with his/her doctor and a nurse in attendance. During the course of the test, the patient walks on the treadmill.

The slope of the treadmill continues to increase and the track on the treadmill becomes more rigid, causing the patient to exert more energy. The heart and lungs are worked to capacity while being monitored.

Heart rate, blood pressure, changes in the EKG pattern, irregular heart rhythm, and the patient's appearance and symptoms are monitored.

Pickett said when the patient's heart rate reaches 85 percent of the maximum level for the patient's age, medication is re-injected through the IV site.

The treadmill test then is finished and the patient is given time for his/her heart to recover to its normal rate.

Images again are taken with the nuclear medicine machine. Those images can show if there are any blocked arteries, or defects in the arteries if blocked or partially blocked.

For those patients who cannot tolerate a treadmill stress test the nuclear medicine department can perform what is termed as a "chemical pharmacological" stress of the heart and achieve the same results as a treadmill stress test.

From there, the doctor will determine the next course of action for his/her patient.

Occasionally the treadmill test is taken without medications.

In all, the testing takes a couple of hours. Following the test, the patient can resume normal activities.

"Oftentimes this test is a precursor to a heart catherization, heart stent, angioplasty, or bypass surgery," Pickett said.

Sometimes the news is good and the patient does not require any further treatment.

"Some people don't realize we have this sophisticated testing available, right here in Marion," Kannady said.