Stress Test Specialist

What is a stress test?

A stress test helps your cardiologist understand how your heart responds to exercise or stress medication. It can help identify problems with blood flow to your heart muscle and guide your care.

SWICFT Cardiology offers stress echocardiograms and two types of nuclear stress testing: single-photon emission computed tomography (SPECT) and positron emission tomography (PET). A stress echocardiogram uses ultrasound to assess your heart's pumping function. SPECT and PET use a small amount of radioactive tracer and a special camera to evaluate blood flow.

What are stress tests used for?

Your SWICFT Cardiology provider may recommend a stress test to evaluate symptoms such as chest discomfort or shortness of breath, investigate suspected coronary artery disease, or assess known heart disease. Results can help your provider decide whether treatment changes or additional testing may be appropriate.

How are SPECT and PET different?

Both tests usually compare blood flow to your heart muscle at rest and during stress. They use different tracers and cameras. SPECT can be performed with treadmill exercise or stress medication. PET is commonly performed with stress medication, although the approach depends on the tracer and testing protocol.

PET provides detailed images and can measure the amount of blood reaching your heart muscle and how that flow increases during stress. These measurements, called myocardial blood flow and flow reserve, can help your cardiologist evaluate the heart's circulation, including its smaller blood vessels. PET studies are often completed more quickly than SPECT studies, and radiation exposure depends on the tracer and protocol used.

Is a stress test right for me?

Your cardiologist reviews your symptoms, medical history, medications, prior tests, and ability to exercise before recommending a test. In its 2026 position statement, the American Society of Nuclear Cardiology (ASNC) recommends PET with myocardial blood flow measurement, when available, for patients with suspected coronary artery disease who are appropriate candidates for this type of nuclear imaging. Your provider will explain which test best answers your clinical question.

Nuclear stress tests are generally safe, but involve radiation exposure and possible side effects from exercise or stress medication. Serious complications are uncommon. Your care team will discuss the benefits and risks for you.

How should I prepare for a stress test?

Follow the written instructions from SWICFT for your specific test. Your team will explain when to stop eating and drinking, how long to avoid caffeine, and how to take your medications. ASNC's updated 2026 guidance emphasizes a 24-hour caffeine-free interval before nuclear stress testing. Confirm your preparation instructions with our team; coffee, tea, energy drinks, chocolate, and even decaffeinated coffee or tea may contain caffeine.

Do not stop or change any medication unless your care team instructs you to do so. Ask for individual instructions if you take insulin or other diabetes medication. Wear comfortable clothes and walking shoes, and bring your inhaler if you use one. Avoid smoking and vaping on the day of your test.

Tell the team in advance if you are pregnant, might be pregnant, or are breastfeeding. If you are unsure about an instruction or could not follow it, contact the office before testing.

What happens during a stress test?

The team places electrodes on your skin to monitor your heart rhythm and uses a cuff to check your blood pressure. During a stress echocardiogram, ultrasound images show how your heart pumps before and after exercise or during medication-induced stress.

For a SPECT or PET nuclear test, a small amount of tracer is injected through an IV in your arm or hand. The camera takes pictures during the resting and stress portions of your study. Your team will explain whether you will exercise or receive stress medication. Stay still during the pictures, and tell the team immediately if you feel unwell or need to stop exercising.

Appointment length varies by test. SPECT may require several hours for preparation, waiting periods, and imaging. PET often takes less time, but your team will confirm the expected length and schedule of your visit.

What should I expect after my test?

Most patients can return to their usual activities unless instructed otherwise. Follow your team's directions about medications, fluids, and any temporary precautions related to the tracer you received. If you have a fluid restriction, ask how much you should drink afterward.

Your SWICFT Cardiology provider will review the results with you and explain what they mean for your care, including whether further testing or treatment is needed.

For questions or to schedule an appointment, call SWICFT Cardiology at 239-261-2000.

Where can I learn more?

ASNC patient guide: Your Nuclear Stress Test: What You Need to Know (PDF, opens in a new tab)

ASNC clinical reference: Clinical Value of Cardiac PET (PDF, opens in a new tab). This resource provides more technical information for readers who would like additional detail.

These resources provide general education. Follow the instructions provided by SWICFT for your individual test.