Can you help me understand the results of a stress test? What are they looking for? 

Submitted by Howard from Texas on 05/14/2015

by Warren H. Moore, MD

A “nuclear medicine stress test “is really two separate tests; one is the “nuclear” (or imaging (picture)) part of the test and the other is the “stress” (or ECG) part of the test (which in this case involved using a drug as a substitute for exercise as a way of stressing the heart to test its blood flow). Each of these parts yields its own answer to one aspect of the patient’s problem, and each of those parts of the answer may be effectively “yes,” “no,” or “maybe.” Often both parts come to the same conclusion, or one part is so strong in its answer that it makes the overall answer clear. In this patient’s case, however, given the reports provided, it appears that the overall answer might be “maybe.”

At this point, the patient should sit with the practitioner that ordered the test and discuss several questions. Why was the test ordered? What was the overall result of the test? (And most importantly) what is the next step for the patient’s care? The answers depend in part on many factors which are not covered in this query, and may require some discussion between the ordering practitioner, the “radiologist” interpreting the “nuclear” portion, and the cardiologist who interpreted the “stress” portion. Depending particularly on the reason for the test and the patient’s symptoms, a course of action may be clear enough to proceed with or further testing may be necessary.