IMPORTANT: If you have a pacemaker/defibrillator, it must be checked before your metabolic stress test. Please call your doctor to schedule a device check.
The metabolic stress test involves exercising on a treadmill or stationary cycle while you are closely monitored and breathing through a mouthpiece and/or face mask.
Why is this test performed?
The metabolic stress test measures the performance of the heart and lungs while they are under physical stress.
If you have shortness of breath or chronic fatigue, the metabolic stress test can determine if your symptoms are due to a medical problem (such as heart or lung disease) or due to poor fitness. The test is also used to:
- Assess how fit your heart and lungs are
- Measure your heart’s ability to do work (functional capacity)
- Determine if certain surgical treatments are appropriate for you
- Evaluate the effectiveness of your cardiac treatment plan
- Help you develop a safe and effective exercise program
Can I eat or drink on the day of the test?
- Yes. However, DO NOT eat or drink anything except water for four hours before the test.
- Avoid all products that contain caffeine for 24 hours before the test. In general, caffeine is found in coffee, tea, colas and other soft drinks, most chocolate products, as well as strawberries (these contain a small amount of caffeine), as caffeine will interfere with the results of the test. Also avoid decaffeinated or caffeine-free products for 24 hours before the test, as these product contain trace amounts of caffeine.
- DO NOT SMOKE ON THE DAY OF THE TEST, as nicotine will interfere with the results of your test.
Should I take my medications the day of the test?
Since many over-the-counter medications contain caffeine (such as diet pills, NoDoz®, Excedrin® and Anacin®), DO NOT take any over-the-counter medication that contains caffeine for 24 hours before the test. Ask your physician, pharmacist or nurse if you have questions about other medications that may contain caffeine.
DO NOT take the following heart medications on the day of your test unless your physician tells you otherwise or if it is needed to treat chest discomfort the day of the test:
- Isosorbide dinitrate (for example: Dilatrate®, Isordil®)
- Isosorbide mononitrate (for example: Imdur®, Ismo®, Monoket®)
- Nitroglycerin (for example: Minitran®, Nitropatches®, Nitrostat®)
- Your physician may also ask you to stop taking other heart medications on the day of your test. If you have any questions about your medications, ask your physician.
- If you use an inhaler for your breathing, please bring it to the test.
- NOTE: Do not discontinue any medication without first talking with your physician.
Guidelines for people with diabetes
If you take insulin to control your blood sugar, ask your physician what amount of your medication you should take the day of the test. Often, your physician will tell you to take only half of your usual morning dose and to eat a light meal four hours before the test. If you take pills to control your blood sugar, do not take your medication until after the test is complete.
Do not take your diabetes medication and skip a meal before the test.
If you own a glucose monitor, bring it with you to check your blood sugar levels before and after your test. If you think your blood sugar is low, tell the lab personnel immediately. Plan to eat and take your diabetes medication following your test.
What should I wear on the day of the test?
Please wear or bring comfortable clothes and shoes suitable for walking. Please do not bring valuables. You will be given a locker to store your belongings during the test.
What happens during the test?
- Your test will take place in the Stress Lab. The testing area is supervised by a physician.
- First, a stress lab technician will gently rub 10 small areas on your chest and place electrodes (small, flat, sticky patches) on these areas. The electrodes are attached to an electrocardiograph (EKG) monitor that charts your heart’s electrical activity during the test.
- Before you start exercising, the technician will perform a resting EKG, measure your resting heart rate and take your blood pressure.
- You will be asked to breathe through a mouthpiece and/or face mask for a few minutes before the test and throughout the test. A nose-clip will be placed on your nose so you breathe only through your mouth.
- You will exercise on a treadmill or stationary cycle. The lab personnel will ask you to start exercising and will gradually increase the intensity of exercise. You will be asked to continue exercising until you are exhausted.
- At regular intervals, the lab personnel will ask how you are feeling. Since you will be unable to speak with the mouthpiece or mask in place, they will questions that can be answered by nodding your head “yes” or shaking your head “no”. Please tell the lab personnel if you feel chest, arm or jaw pain or discomfort; short of breath, dizzy, lightheaded or if you have any other unusual symptoms.
- The lab personnel will watch for any changes on the EKG monitor that suggest the test should be stopped.
- After the test, you will walk slowly for a few minutes to cool down. Your heart rate, blood pressure and EKG will continue to be monitored until the levels are returning to normal.
How will I feel during the test?
You will be encouraged to exercise until you are exhausted. It is normal for your heart rate, blood pressure, breathing rate and perspiration to increase. You may also have a dry mouth from breathing through the mouthpiece.
How long does the test take?
The appointment will take about 75 minutes. The actual exercise time is usually between five and 12 minutes.
How do I get the results of my test?
After a cardiologist has reviewed your test, the results will be entered into your electronic medical record. Your physician will have access to the results and will discuss them with you.
This information is about testing and procedures and may include instructions specific to Cleveland Clinic. Please consult your physician for information pertaining to your testing.