Preparing for a Cardiac Stress Test in Ajax
Plan your treadmill stress test in Ajax step by step, from asking about beta blockers a week ahead to what to wear, what to bring and how the test unfolds.
· 8 min read
A cardiac stress test is one of the few medical appointments where your clothing and footwear genuinely matter. It is also one where a conversation with your doctor a few days beforehand can make a real difference. Because of that, the best way to prepare is not on the morning of the test but over the days leading up to it.
This guide is organized as a countdown. It starts as soon as you receive your requisition and finishes after you walk out of the clinic. Everything here is based on the preparation instructions that Durham Cardiology, the cardiology team at Rossland Diagnostic Clinic in Ajax, gives to patients, along with general, common-sense advice. Your own provider’s instructions always come first.
A stress test is a planned outpatient test, not emergency care. If you have chest pain, pressure or tightness, pain spreading to your arm, jaw, neck or back, sudden shortness of breath, cold sweats or fainting, or signs of a stroke such as a drooping face, arm weakness or slurred speech, call 911 right away. Do not wait for your appointment and do not drive yourself.
Why your heart is tested while it works
At rest, many hearts look and sound completely normal, even when there is an issue that only shows up under effort. Walking briskly uphill asks the heart to beat faster and harder and to receive more blood through the coronary arteries. If something limits that supply or triggers an unusual rhythm, it is more likely to appear during exercise.
That is the reason for a treadmill stress test. According to Durham Cardiology’s test information, it can help evaluate coronary artery disease, abnormal heart rhythms brought on by exercise, and exercise capacity, meaning how much activity your body can comfortably handle. The test itself takes about 30 minutes.
If you would like an overview of all the heart tests our team offers before you focus on this one, see our article on heart testing in Ajax.
As soon as you have your requisition
Check exactly which test you are booked for
Durham Cardiology offers a stress test, a stress echocardiogram and myocardial perfusion imaging, and all three can involve the heart working harder. They are different tests with different instructions and appointment lengths. Look at your requisition carefully. If it is not clear which test has been requested, call the clinic or your provider’s office before you book.
This article is about the standard treadmill stress test. If you have been booked for a stress echocardiogram, many of the same tips apply, but allow 60 to 90 minutes. If you have been booked for myocardial perfusion imaging, our team will give you protocol-specific instructions when your appointment is confirmed.
Book a time that suits your body
Think about when you usually feel your best. Some people move more easily in the morning; others are stiff until midday. Our clinic is open Monday to Friday from 9:00am to 5:00pm and Saturday from 8:00am to 3:30pm. A Saturday slot can work well if you would otherwise be squeezing the test into a busy workday.
About a week before
The medication conversation
This is the most important step in the whole countdown.
If you take a beta blocker, consult your referring physician about whether you should pause it before the test. Beta blockers are medications that slow the heart rate, and examples include bisoprolol, atenolol and metoprolol. Because a stress test looks at how your heart responds to effort, a medication that holds the heart rate down can affect the test. Your physician will weigh that against your safety and decide.
Two firm rules:
- Never stop any medication without your doctor’s approval. Stopping some heart medications suddenly can be risky.
- Do not guess. If you are unsure whether one of your pills is a beta blocker, ask your doctor or pharmacist.
It helps to make this call early. Leaving it until the day before can mean you cannot reach your provider in time.
Write your medication list
You will need to bring a current medication list. Include prescription medicines, over-the-counter products, inhalers, vitamins and supplements, along with doses if you know them. A photo of your pill bottles is better than nothing, but a written list is easier for staff to read.
Think about your symptoms
If you have been having symptoms, jot down what they feel like, when they happen and what you were doing. Being able to describe them clearly helps the team monitoring your test and gives your provider useful context.
The day before
Lay out what you will wear and bring. It sounds simple, but it avoids a last-minute scramble.
Clothing:
- Running shoes or comfortable walking shoes with a good grip. Durham Cardiology asks patients to wear running shoes. Dress shoes, sandals and heels are not safe on a moving treadmill.
- Comfortable clothing you can walk briskly in, such as athletic pants and a loose top.
- A top that is easy to open or remove, since electrodes go on your chest.
Documents:
- your signed requisition
- your valid OHIP card
- your current medication list
If you have been given any other instructions about eating, drinking, caffeine or smoking before the test, follow them. If you have not and you are unsure, call the clinic to confirm rather than assuming.
The morning of the test
- Skip cream, lotion or body oil on your chest and upper body. Electrodes need clean, dry skin to stick and record properly.
- Take or hold medications exactly as your physician told you.
- Leave enough time to arrive 15 minutes early. Rushing in breathless and flustered is not the best way to start an exercise test.
Rossland Diagnostic Clinic is at Unit 102, 300 Rossland Road East in Ajax. Parking is free and the entrance is at ground level, so there are no stairs to climb before your test. Patients come to us from across Ajax, Pickering, Whitby and Durham Region, so check your travel time on the day.
During the test
Knowing the sequence ahead of time can take a lot of the nervousness out of it.
- Electrodes go on. Small sticky electrodes are placed on your chest and connected to monitoring equipment.
- Resting readings. A resting EKG and a blood pressure reading are taken before you start moving. These give a baseline to compare against.
- The treadmill starts slowly. You begin at an easy walking pace.
- It gradually gets harder. At set intervals the treadmill increases in speed and incline. You will feel your heart rate and breathing pick up, just as they would on a steep walk.
- You are monitored throughout. Your heart rhythm and blood pressure are watched as you go.
- Recovery. When the exercise portion ends, monitoring continues for a short time as your heart rate settles.
Speak up
The staff want to know how you feel during the test. Tell them straight away if you notice chest discomfort, unusual shortness of breath, dizziness, leg pain or anything else that worries you. You are not being graded on how long you can walk. Honest feedback is part of what makes the test safe and useful.
Use the handrails as instructed
Stepping onto a moving treadmill can feel awkward if you are not used to one. Ask the team to show you how to get on and off safely and how to use the handrails. If you have balance concerns, joint problems or a mobility aid, mention it when you book and again when you arrive.
If you feel nervous
It is common to feel uneasy about exercising while your heart is being watched, particularly if you have had symptoms that frightened you. A few things can help. Remember that you are monitored the whole time, by people whose job is to watch for exactly the changes you are worried about. Focus on steady breathing and a natural walking rhythm rather than on the screen. And keep in mind that the purpose of the test is to gather information so that you and your provider can make good decisions together. Feeling anxious is understandable, and the team will not mind if you say so.
Afterward
Most people feel a little tired, much like after a brisk walk. Have some water and give yourself a few minutes before heading out.
Your results are reviewed and a report is sent to the physician who ordered the test. They will explain what the findings mean and whether any other testing is recommended. A stress test is often one part of a broader assessment, and your provider may combine it with other information, such as an echocardiogram or blood tests, before drawing conclusions.
If you paused a medication for the test, ask your physician beforehand when to restart it, so you are not left unsure afterward.
If any of the symptoms listed at the top of this article appear after you leave, call 911.
Your countdown at a glance
| When | What to do |
|---|---|
| On receiving the requisition | Confirm which test you are booked for and choose a good time |
| About a week before | Ask your physician about beta blockers and any other medications |
| A few days before | Write your medication list and note any symptoms |
| The day before | Lay out running shoes, comfortable clothes and documents |
| The morning of | No upper-body lotion, medications as instructed, arrive 15 minutes early |
| During the test | Tell staff about any symptoms straight away |
| Afterward | Rest briefly and follow up with your provider about results |
If you have a requisition for a stress test, call Durham Cardiology at Rossland Diagnostic Clinic on 905-426-3111, or request an appointment and our team will contact you to arrange a time that works for you.