Cardiac Stress Test: Types, What to Expect & Results

A cardiac stress test checks how your heart performs under increased workload — a key way to detect coronary artery disease. Here are the types, what happens during each, and how the results are read.

What is a cardiac stress test?

A cardiac stress test records the heart's response to exertion, revealing reduced blood flow (ischaemia) that may not show up at rest. As the heart works harder, a narrowed coronary artery can't keep up, producing ECG changes, symptoms, or imaging abnormalities.

Types of stress test

Type	How the heart is stressed	How it's assessed
Exercise treadmill	Walking on a treadmill	ECG and symptoms
Pharmacologic	A drug (regadenoson/Lexiscan, adenosine, or dobutamine) for those who can't exercise	Imaging or ECG
Nuclear (myocardial perfusion)	Exercise or drug	A radiotracer shows perfusion at stress vs rest
Stress echocardiogram	Exercise or dobutamine	Ultrasound of wall motion

What to expect

You'll have ECG electrodes placed and, for imaging studies, an IV line. For an exercise test you walk on a treadmill that gets progressively harder; for a pharmacologic test a medication mimics that stress. The team monitors your ECG, blood pressure, and symptoms throughout. The whole visit typically takes one to a few hours, mostly preparation and imaging.

What the results mean

• Normal — the heart handled the stress with no ischaemic changes; coronary disease is less likely.
• Positive (abnormal) — ECG changes, symptoms, or a perfusion/wall-motion defect suggest a flow-limiting coronary narrowing, often prompting angiography.

Key takeaways

• A stress test detects ischaemia by loading the heart.
• Stress is applied by exercise or a drug (Lexiscan, adenosine, dobutamine).
• Assessment is by ECG, nuclear perfusion, or stress echo.
• A positive test often leads to coronary angiography.

Frequently asked questions

What is a cardiac stress test?

A test that records the heart's response to exertion — from exercise or a medication — to reveal reduced blood flow (ischaemia) suggesting coronary artery disease.

What is a Lexiscan (pharmacologic) stress test?

A stress test that uses a drug such as regadenoson (Lexiscan), adenosine, or dobutamine to increase cardiac workload for patients who cannot exercise, usually combined with imaging.

What are the types of cardiac stress test?

Exercise treadmill (ECG), pharmacologic, nuclear myocardial perfusion imaging, and stress echocardiography.

What does a positive stress test mean?

ECG changes, symptoms, or an imaging defect during stress suggest a flow-limiting coronary narrowing, which often leads to coronary angiography.

How long does a cardiac stress test take?

The visit usually takes one to a few hours, most of it preparation and imaging; the exercise or drug-stress portion itself is shorter.