Home Feedback Email Us



What is a stress test? Do I need a stress test?
A stress test (also called a treadmill test or exercise test) helps your doctor find out how well your heart handles work. As your body works harder during the test, it requires more fuel and your heart has to pump more blood. The test can show if there is a lack of blood supply through the arteries that go to the heart. Taking a stress test also helps your doctor know the kind and level of exercise that's right for you.

What happens during the test?

You are hooked up to equipment to monitor your heart
You walk at a slow pace on the treadmill
It tilts so you feel like you're going up a small hill
The speeds are changed to make you walk faster
You may be asked to breathe into a tube for a couple of minutes.
You can stop the test at any time if you need to
Afterwards you will sit or lie down and your heart and blood pressure will be checked

What is monitored during the test?
Your heart rate
Your breathing
Your blood pressure
Your electrocardiogram (ECG or EKG)
How tired you feel

What equipment is used?
The electrocardiogram or ECG machine will record your heartbeat. Tiny wires or electrodes will be hooked up to your chest and arms or shoulders. Near the end, you may breathe into a mouthpiece that will measure the air you breathe out.

Is there a risk?
There is very little risk no more than if you walked fast or jogged up a big hill. Medical professionals are on hand in case anything unusual happens during the test.



How long do I have to be on the treadmill?
The average Stress Test will take approx. 6-9 minutes. However people who are in better physical condition will need to stay on the treadmill for a longer period of time. We ask patients to exercise to full fatigue for optimal results.

What information does a stress test give?
Stress testing will give us information about your functional capacity, or activities you can perform on a daily basis. The stress test measures your functional capacity in units called Metabolic Equivalents (METS). Consequently, the longer someone can stay on the treadmill, the higher the METS or functional capacity. The test will also give us information about the blood flow to your heart. If during your test you develop chest pain or abnormalities in your EKG, this may indicate Ischemia or lack of blood flow to your heart. Further testing may be performed at that point to determine the severity of the abnormality.

What should I wear to walk on the treadmill?
We ask that patients wear sneakers, loose fitting comfortable clothes, and preferably a shirt with buttons.

What do I need to know before I have my stress test? (Medication, food, drinks, lotions/powders on chest)?
Before your stress test, you should take all medications unless otherwise told by your physician

You should eat a light meal about 4 hours before your test (2 hrs. if Diabetic)

Do not apply any lotions, powder or deodorant to the chest area

Bring an updated list of all your medications

Expect your chest to be sponged lightly with a mild abrasive, followed by placement of 10 electrodes

The electrodes will serve as hook-up for your EKG. This will allow our physician Asst (PA) to monitor your EKG for changes



What is Echocardiography?
Echocardiography (, also called an echo test) is a test that takes "moving pictures of the heart with sound waves. You don't have to stay in the hospital; it is not surgery and does not hurt. This test is done to help your doctor find out if you have problems with your heart or with how it's working

Echocardiography is needed if:
You have a heart murmur
You have had a heart attack
You have unexplained chest pains
You have had rheumatic fever
You have a congenital heart defect

How is it done?
You'll lie on a bed on your side or back
A technician will put special jelly on a probe and move it over your chest area
Ultra-high-frequency sound waves will pick up images of your heart and valves. No x-rays will be used
Your heart movements can be seen on a video screen
A video tape or a photograph can be made of the pictures
You can watch during the test
It usually takes less than 15-20 minutes
It's painless and has no side effects
Your doctor will talk to you about the results

What will the test show?
The size and shape of your heart
How well your heart is working overall
If a wall or section of heart muscle is weak and not working correctly
If you have problems with your heart valves
If you have a blood clot

How do I walk on a treadmill?
There really is no special way to walk on a treadmill. We just ask that you walk the way you normally do. If you do have some difficulty a CVT a PA will help you.



You may get medicine through an IV (intravenous line) to relax you. You will also have an injection to numb the insertion site. A tiny skin incision is made in your groin. This is the insertion site. Your doctor inserts a catheter (thin tube) into the site and slides it through an artery while viewing a video monitor. A contrast "dye" is injected into the catheter (thin tube) into the site and slides it through an artery while viewing a monitor. A tiny balloon is pushed through the catheter to the blockage. The doctor inflates and deflates the balloon a few times to compress the plaque. You may feel pressure. The balloon and catheter are then removed. Pressure is applied to the insertion site by hand or with a special belt.

What is a Stent and why is it needed?
A stent is a small metal or mesh tube. It is sometimes used to help keep your artery open. If you need a stent, your doctor will place it in your artery during angioplasty. He or she fits the stent over a balloon. The balloon and stent then slide through the catheter to the area where the blockage is. Your doctor inflates the balloon. This presses the stent against the artery wall. The balloon is removed while the stent stays in place.

What will happen after the angioplasty?
You will be taken to a recovery area. A doctor or nurse will keep applying pressure for about 15 minutes. You will need to keep your leg still and straight for several hours.
You will either go home later that day or spend the night in the facility
You will have a small bandage over the insertion site. You can remove it in 1 or 2 days.

On the day you get home:
Do not drive
Do not exercise
Avoid walking and taking stairs
Avoid bending and lifting
Your doctor may give you other care instructions
You can resume your normal activities in a day or two after consulting your doctor

Immediately call the physician if:
You notice a lump or bleeding at the insertion site
You feel pain at the insertion site
You become lightheaded or dizzy
You have leg pain or numbness



What is cardiac catheterization?
Cardiac Catheterization is common, relatively painless, nonsurgical procedure that can help your doctor diagnose a heart problem. To perform the procedure a cardiologist inserts a long, flexible tube called a catheter into an artery and gently guides it toward your heart. Once the catheter is in place, x-rays and other tests are done to help your doctor evaluate how well your heart is working.

Cardiac Catheterization can show:
If the blood vessels in your heart are clogged
If your heart is pumping normally can blood is flowing correctly
If you were born with any heart problems

What do I need to know about cardiac catheterization?
Cardiac catheterization is performed to detect the presence of heart disease, determine its severity, and learn how it affects the heart's capacity to function. The test results help to diagnose and treat the condition. On the day before the procedure, you will probably be asked not to eat or drink anything after midnight, and your groin or forearm will be shaved.

What is the catheterization procedure?
Cardiac catheterization is performed by a cardiologist in a special laboratory, under sterile conditions. Before the procedure, the area that was shaved will be scrubbed with an antiseptic agent. You will then receive an injection of local anesthetic just beneath the skin. The injection may feel similar to that of a bee sting. The doctor will then insert one or more sterilized, fluid-filled thin plastic tubes (catheters) into a blood vessel in your arm or groin. More than one catheter may be inserted into an artery and vein at the same time, or a catheter in the artery or vain may be exchanged sequentially for another catheter. The doctor then gently advances the catheter through the blood vessels and into your heart with the aid of an x-ray machine (fluoroscope). The blood vessels and heart do not have nerves in the inner linings; therefore the procedure causes minimal discomfort. With the catheter in place, the doctor next measures the pumping capacity of your heart as well as the blood pressure in the various chambers of your heart and lungs. These measurements enable the cardiologist to determine the effectiveness of the heart as a pump and whether or not has been impaired by any disease process that can harm the valves of the heart muscle or coronary arteries.

During the procedure, a dye that shows up on x-ray is rapidly injected into the chambers of your heart. This allows your doctor to produce a ventriculogram, or movie, of the heart as it pumps. As the dye is injected, you may experience a sensation of warmth or flushing, but this is a normal reaction, and will last only 20-30 seconds. The dye is also injected directly into your coronary arteries, which deliver oxygen-containing blood to the heart muscle. Here, you may also experience transient chest discomfort while the dye is injected. The movie of the dye flowing through the coronary arteries is called a coronary arteriogram. Depending on your medical condition, the cardiologist may also need to administer certain additional drugs. Drugs are given to thin the blood (heparin), to dilate the coronary arteries and reduce the workload of the heart (nitroglycerin), to control the heart's rhythm (antiarrhythmics), and/or to relieve angina.You will need to lie still throughout the procedure, on a firm, thin, x-ray table, which does cause some back discomfort.

What is the proper follow-up care?
After the procedure has been completed, your care is determined in part by the site of catheter entry. If the procedure has been done through a blood vessel in the groin, you will usually need to lie flat on your back for at least 6 hours and sometimes for as long as 12 to 18 hours. Most patients can go home on the morning after the procedure, though many hospitals now do this as an outpatient procedure, so that the patient can go home late in the afternoon or early in the evening following an early morning procedure. If the catheterization is done via the arm, you usually do not need to stay in bed afterwards and sometimes can go home four to six hours later. Your physician will advise necessary restrictions of work or physical activity depending on your cardiac condition.

What are some possible complications?
The risks of cardiac catheterization include the possibility of blood clot forming that causes a stroke or heart attack, bleeding, damage or obstruction of a blood vessel and even death. However, in medically stable patients undergoing elective cardiac catheterization for the evaluation of coronary artery or vavular hear disease, the risk of a potentially fatal result is less than 1 in 500 cases

If there is swelling or bleeding from the catheterization site or if the extremity becomes cold, pale, or numb following discharge, you must immediately contact your physician.
Catheterization Prep

Before your cardiac catheterization, your doctor will explain the procedure, risks and benefits. You will be asked to sign a legal consent form. This gives your doctor permission to perform the procedure.

What do I need to know before the procedure?
If your catheterization is scheduled for early morning, you probably will not be allowed to eat or drink anything after midnight . To protect against infection, the skin where the catheter will be inserted may be shaved and prepared with an antiseptic solution.

What should I expect during the procedure?
When you reach the catheterization laboratory, you will be placed on a narrow padded table. During catheterization, the physician will move the table to view your heart from different angles. The X-ray camera will be moved around you to get the best possible pictures. Special foam pads, called electrodes, will be placed on your chest and connected to a monitor so that your heartbeat can be monitored.

Cardiac catheterization usually takes 1 hour or less. You will be awake throughout the procedure, although the physician may order some medication to help you relax. (Some patients even doze off.)

When the physician is ready to begin, he will inject a local anesthetic at the insertion site. The injection may feel a little uncomfortable, but it will numb the area before he puts in the catheter. When the catheter is going in, you should feel a little pressure but no pain.

If the catheter meets blockage-where arteriosclerosis has narrowed a blood vessel, for example-the physician will withdraw the catheter and start from another insertion area.

When the catheter enters your heart, you may experience a fluttering or flip-flop sensation. Tell the physician if you do but do not be alarmed as it is a normal reaction. You are likely to feel a warm sensation, some nausea or the urge to urinate if dye is injected but these feelings will pass quickly. Throughout the procedure, remember to let the physician or the nurse know if you have chest pain.

During the procedure, your physician may ask you to cough. These actions help to advance the dye through your heart. The physician may also ask you to breathe deeply, which will give him a better view of your heart. When the physician removes the catheter, he will put a special bandage on your arm or groin. Along with the bandage you will also have a sandbag applied for 4-6 hours. The anesthetic will still be working, so you should not feel anything.

What do I need to know after the procedure?
After your catheterization, you'll need to remain lying down for 4-6 hours. If the catheter was inserted in your groin, you'll be asked not to move your leg to prevent bleeding.

The nurse will do frequent blood pressures and checking of the insertion site, so do not be alarmed. The x-ray contrast liquid may cause you to urinate more than usual. You may be asked to drink a lot of fluid to help flush the contrast liquid out of your system.

Inform the Nurse:
If you feel any chest pain or discomfort at the insertion site
The arm or leg used for insertion becomes cold or numb
You feel warmth or wetness around the insertion site
As soon as the test results are available, the physician will talk to you and your family about them
Do not hesitate to ask the doctor or nurse any questions you may have

Call Your Doctor If:
The insertion site begins to bleed
You feel any chest pain or discomfort at the insertion site
The arm or leg in which the catheter was inserted feels cold or numb
Bruising or swelling increases


Copyright © 2011 Karachi Institute of Heart Diseases.
All Rights Reserved.
Serve the Nation
Powered by: IT Department of KIHD