运动压力测试

定义

An exercise stress test is used to measure the effect of exercise on your heart.

选择的名字

Exercise ECG; ECG - exercise treadmill; EKG - exercise treadmill; Stress ECG; Exercise electrocardiography; Stress test - exercise treadmill; CAD - treadmill; Coronary artery disease - treadmill; Chest pain - treadmill; Angina - treadmill; Heart disease - treadmill

如何执行测试

This test is done at a medical center or health care provider's office.

The technician will place 10 flat, sticky patches called electrodes on your chest. These patches are attached to an ECG monitor that follows the electrical activity of your heart during the test.

You will walk on a treadmill or pedal on an exercise bicycle. 慢慢地(大约每3分钟), you will be asked to walk (or pedal) faster and on an incline or with more resistance. 这就像快走或慢跑上山.

While you exercise, the activity of your heart is measured with an electrocardiogram (ECG). 你的血压读数也会被记录下来.

测试将持续到:

• 你达到了一个目标 心率.
• 你开发 胸部疼痛 或者你的血压发生了令人担忧的变化.
• ECG changes suggest that your heart muscle is not getting enough oxygen.
• You are too tired or have other symptoms, such as leg pain, that keep you from continuing.

You will be monitored for 10 to 15 minutes after exercising, 或者直到你的心率恢复到基线. 考试总时间约为60分钟.

如何准备考试

Wear comfortable shoes and loose clothing to allow you to exercise.

Ask your provider if you should take any of your regular medicines on the day of the test. 有些药物可能会影响检测结果. Never stop taking any medicine without first talking to your doctor.

Tell your provider if you are taking sildenafil citrate (Viagra), 他达拉非(西力士), or vardenafil (Levitra) and have taken a dose within the past 24 to 48 hours.

你不能吃东西, 烟, or drink beverages containing caffeine or alcohol for 3 hours (or more) before the test. 在大多数情况下, you will be asked to avoid caffeine or caffeine-like substances for 24 hours before the test. 这包括:

• 茶和咖啡
• 所有的苏打水，即使是那些标有不含咖啡因的
• 巧克力
• 某些含有咖啡因的止痛药

考试的感觉如何

Electrodes (conductive patches) will be placed on your chest to record the heart's activity. The preparation of the electrode sites on your chest may produce a mild burning or stinging sensation.

The blood pressure cuff on your arm will be inflated every few minutes. 这会产生一种挤压感，感觉很紧. Baseline measurements of 心率 and blood pressure will be taken before exercise starts.

You will start walking on a treadmill or pedaling a stationary bicycle. The pace and incline of the treadmill (or the pedaling resistance) will slowly be increased.

Sometimes, people experience some of the following symptoms during the test:

• 胸部不适
• 头晕
• 心慌
• 呼吸急促（气促）

为什么要进行测试

Reasons why an exercise stress test may be performed include:

• You are having 胸部疼痛 (to check for 冠状动脉疾病, (输送心肌的动脉变窄).
• 你的 心绞痛 是变得更糟了还是更频繁了.
• 你心脏病发作了.
• 你做过血管成形术或者 心脏搭桥手术.
• You are going to start an exercise program and you have heart disease or certain risk factors, 比如糖尿病.
• To identify heart rhythm changes that may occur 在运动中.
• 进一步检查心脏瓣膜问题(比如 主动脉瓣 or 二尖瓣狭窄).

There may be other reasons why your provider asks for this test.

正常的结果

A normal test will most often mean that you were able to exercise as long as or longer than most people of 你的年龄 and sex. You also did not have symptoms or concerning changes in blood pressure or your ECG.

The meaning of your test results depends on the reason for the test, 你的年龄, 还有你的心脏病史和其他医疗问题.

It may be hard to interpret the results of an exercise-only stress test in some people.

异常结果意味着什么

异常结果可能是由于:

• 心律失常 在运动中
• Changes in your ECG that may mean there is a blockage in the arteries that supply your heart (冠状动脉疾病)

当你的运动压力测试异常时, 您可以对您的心脏进行其他测试，例如:

• 心导管检查
• 核压力试验
• 应力超声心动图

风险

压力测试通常是安全的. 有些人可能会有胸痛或晕厥或晕倒. 心脏病发作或危险的不规则心律是罕见的.

People who are more likely to have such complications are often already known to have heart problems, 所以他们没有做这个测试.

参考文献

Balady GJ, Ades PA. Exercise physiology and exercise electrocardiographic testing. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12日艾德. Philadelphia, PA: Elsevier; 2022:chap 15.

Fihn SD, Blankenship JC, Alexander KP，等. 2014 ACC/AHA/AATS/PCNA/SCAI/STS focused update of the guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines, 以及美国胸外科协会, 预防心血管护士协会, 心血管血管造影与干预学会, 和胸外科学会. 我是科尔·卡迪诺. 2014;64(18):1929-1949. PMID: 25077860 pubmed.ncbi.nlm.国家卫生研究院.gov / 25077860 /.

小戈夫DC, lloyd - jones DM, 班尼特克, et al; American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2013 ACC/AHA Guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 我是科尔·卡迪诺. 2014;63(5辑B):2935-2959. PMID: 24239921 pubmed.ncbi.nlm.国家卫生研究院.gov / 24239921 /.

莫罗检察官，德莱莫斯法官. 稳定性缺血性心脏病. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12日艾德. Philadelphia, PA: Elsevier; 2022:chap 40.