Can You Eat Before a Stress Test?

One thing I have learned from my time working on a cardiac unit is that people do not like waiting to get tests done. Partly because they are not allowed to eat before certain tests. And like many cardiac tests and procedures, a stress test is no different. So, can you eat before a stress test?

The short answer is, unfortunately, no. But on occasion, depending on the facility performing the test, a light breakfast or lunch is allowed.

Feel free to read on to find out what a stress test is, what it measures, why you might need one, and what to expect on the day of your procedure.

>>Skip to a quick STRESS TEST PREP CHECKLIST<<

What is a Stress Test?

This noninvasive test is used to analyze how your heart reacts under cardiovascular “stress”. This is a great way to prognose your risk of heart disease and provide some answers to why you may be experiencing the symptoms you’re having.

It is very safe and all testing is done in a lab, clinic, or hospital. Likewise, a trained medical professional will be monitoring you the entire time. The only stress your body will be under is from one of three activities: 1) walking on a treadmill, 2) biking on a stationary bike, or 3) medically-induced heart-rate raising drugs.

It is also important for you to know that stress tests are usually only useful on patients with intermediate risk for CAD. Studies show that those who are at low risk may have false positives. For low-risk patients, a cardiac catheterization procedure is recommended instead.

What Is Monitored During a Stress Test?

Now that you are aware that the purpose of a stress test is to analyze and prognose possible heart disease, let’s answer the question of what is being monitored throughout your test.

Throughout the testing period, trained medical staff will be constantly monitoring several things:

  • Your heart rate
  • Your breathing
  • How tired or out of breath you are
  • Your blood pressure
  • Your electrocardiogram (ECG or EKG)

If you have any concerns during the test, it can be stopped at any time. Let your technician know if you are having any dizziness, fatigue, chest pain, shortness of breath, or other symptoms that make you unable to continue. Likewise, the technician will be asking you throughout your test how you are feeling to make sure you are okay to continue.

Signs You Need a Stress Test

A stress test shows whether or not your heart’s blood supply is sufficient and if your heart rhythm is normal. A stress test may be recommended by your doctor for several reasons, especially if any of the following applies to you:

  • You have chest pain, shortness of breath, dizziness, lightheadedness, or other signs of heart disease
  • You have had a recent coronary angioplasty with stenting or cardiac bypass surgery
  • If you are at high risk for developing heart disease
  • If you notice any heart rhythm changes – usually experienced during exercise

Types of Stress Tests

There are different types of stress tests as seen in the graphic below. I’ll provide a brief explanation of each type of stress test.

Types of Stress Tests

Treadmill Stress Test

Also known as an exercise stress test or treadmill test.

You will first have electrodes (flat, sticky pads) placed on your chest area. The electrodes are connected to a machine that will monitor your heart throughout your test.

You will then be asked to walk slowly on a treadmill. The speed and/or incline will be adjusted as you go to a faster pace to mimic the effect of going up a small hill. This is done to raise your heart rate to a specific target rate.

At some point, you may be asked to breathe into a mouthpiece or face mask for a couple of minutes. This is to monitor your breathing throughout the exercise.

When you are done on the treadmill, you will have to sit or lie down with the electrodes still in place. Technicians will monitor your heart rate and other vital signs such as blood pressure as they return to normal.

Stress Echo (Treadmill)

This test involves a doctor being present and a sonographer. A sonographer is a medical professional who is trained in using imaging equipment that uses sound waves to produce a picture of a specific body part.

First, the sonographer will place electrodes on your chest. The electrodes will be attached to a monitor that will monitor your heart throughout the test.

Secondly, you will have a resting EKG done to measure your heart rate and blood pressure while at rest. A resting echo, or ultrasound, will also be done. You will have to lie on your left side while the sonographer places a wand (called a transducer) on your chest to capture an image of your heart’s movement and structures.

Then you will finally start the treadmill part of the test. Like the exercise stress test, you will start exercising slowly and then work your way up to a more intense pace and incline.

Your heart rate, blood pressure, and how you are breathing will be monitored throughout the test and you can stop if you are having any chest pain, severe shortness of breath, or are too exhausted.

When this is done, you will lie back on an exam table to have a second echo done. Again, the sonographer will use the wand to capture images of your heart structures. Then you may walk slowly for a few minutes while your vital signs continue to be monitored by a machine until they return to normal.

For an really easy-to-understand video explaining the treadmill stress echo procedure- click here.

picture of what a stress echo procedure looks like

Treadmill Nuclear Stress Test

Also called a nuclear exercise test, this test is similar to a treadmill stress test with the addition of a radioactive tracer being injected into your vein via an IV.

First, a technician will place an IV into a vein in your arm or hand and inject the radioactive tracer. Then you will wait about 20 minutes.

Then the technician will take several images of your heart while at rest. A special camera is used to detect the radiation that the tracer injects to create an image of your heart and the blood flow through it. You will have to lie very still with both arms above your head while the images are taken.

Next, you will have electrodes placed on your chest and a resting EKG will be taken.

Then the treadmill part of the stress test will take place. Like a treadmill stress test, the pace and incline will increase until you reach your target heart rate. A second dose of radioactive tracer will be injected into your IV at this time.

After the treadmill portion is over, you will lie very still again with arms over your head while the second set of images is taken. Each set of images will take about 15-20 minutes.

Adenosine/Persantine Nuclear Stress Test

For patients who are unable to physically complete a treadmill stress test, a pharmacological nuclear stress test is recommended. This type of testing method uses a drug that mimics the effects of exercise on the heart. It is very similar to a treadmill nuclear stress test however does not involve a treadmill.

Another similar type of stress test is a lexiscan stress test. This involves a medication called lexiscan being given intravenously before testing.

First, a radioactive tracer medication is given to you through an IV.

Then you will lie perfectly still while medical staff take images of your heart.

Secondly, you will have electrodes attached to your chest. The technician will then administer the vasodilator through your IV. A vasodilator is used to open up your blood vessels to allow a three to five-time increase in the blood flowing through your vessels. In this case, either adenosine or persantine are used. Persantine is also know as dipyridamole.

The adenosine or persantine may give you a flushed or warm feeling and will cause your heart to react as if you were exercising. A second radioactive tracer will be given during the exam as your heart functioning and vitals continue to be monitored.

Third, you will wait about 30-40 minutes before having more images taken and your vitals return to normal.

Dobutamine Stress Echo

This is another test that involves a sonographer. A sonographer is a medical professional who is trained in using imaging equipment that uses sound waves to produce a picture of a specific body part.

Dobutamine is an alternative drug to adenosine and persantine. It is used in stress tests where patients are unable to physically walk on a treadmill. It is not approved by the FDA and is rarely used currently. However, it can be used in patients who have contraindications to adenosine and persantine- such as in patients who have severe asthma or chronic obstructive pulmonary disease (COPD).

First, a technician will place an IV into a vein in your arm and electrodes on your chest. The electrodes are connected to a machine that will monitor your heart throughout your test.

A resting EKG and echo will be performed. Your vital signs will also be taken at rest and throughout the test. You will have to lie on your left side while the sonographer places a wand (called a transducer) on your chest to capture an image of your heart’s movement and structures. They will take several images throughout your test.

Next, dobutamine will be given through your IV. The dobutamine may give you a flushed or warm feeling and will cause your heart to react as if you were exercising. You may even feel a mild headache.

You can stop the test at any time, especially if you feel any jaw pain, chest pain, dizziness, or shortness of breath. The technician will ask you throughout your test how you are feeling as well.

After the test, the IV will be removed from your arm and your heart rate and vitals will be monitored until they return to normal.

What To Expect

It’s always nice to know what to expect before having any type of medical testing. Your physician, nurse, or lab tech should fill you in on what to do.

For example, certain medications should continue to be taken and others should not. You can always do your own research on what is typical, but consult with your physician or lab that will be performing the test to be sure. Below are some things you can expect the day before testing as well as the day of testing.

The Day Before Your Stress Test

Most facilities prefer you to eat NOTHING after midnight the night before your stress test. However, other medical professionals may say to refrain from eating at least 3 hours before your procedure. Ask your doctor or facility performing the test to be sure.

The reasoning behind not eating or drinking anything is just in case you need any other heart procedures done. If your stress test comes back positive, your cardiologist may want to do a cardiac catheterization or other surgical procedure in which you shouldn’t have a full stomach. Having these procedures done back-to-back will not only cut back on coronary intervention time but also your length of stay at the hospital.

Secondly, you may also want to avoid any caffeine for 12-24 hours before your test. This means staying away from coffee, tea, cola or chocolate.

The reasoning behind avoiding caffeine is that caffeine is a stimulant that raises blood pressure levels. Studies show conflicting evidence on whether or not caffeine is directly linked to heart disease, however.

If you are a smoker, it’s also best to avoid smoking the day prior to your test. This is mainly because the nicotine in cigarettes may affect your test.

The Day of Your Stress Test

It is best to wear loose, comfortable clothing and flat, walking shoes. Wearing a button-up shirt may be best to apply the electrodes to your chest. If you have hair on your chest, they may shave it to better place the electrodes in your chest area. And remember to also bring a list of all your medications with you.

Stress tests can take anywhere from 1 hour to 6 hours, depending on the type of stress test being performed. Therefore, if your stress test is in the early morning, do not expect to be able to eat again until the afternoon or late afternoon.

What NOT To Do Before a Stress Test

There are a few specific things you should avoid before taking a stress test. In most cases, these include:

  • Not eating or drinking before your test- some facilities will allow a light breakfast (see below for an example)
  • No tobacco/nicotine use
  • Avoiding caffeinated beverages and even decaffeinated alternatives such as coffee, teas, chocolate, or medications containing caffeine
  • Avoiding other medications, like beta-blockers

What Is A Light Meal?

If you can eat a meal before your stress test, it’s best to keep things light. Also, make sure you stop eating about 6 to 7 hours before your test, or as instructed.

There are several light meal options to choose from. Here are just a few:

  1. Piece of toast with butter and some juice
  2. A small bowl of hot or cold cereal with milk
  3. Piece of toast with jelly and a glass of milk
  4. Low-fat yogurt and some fruit
  5. A fruit smoothie
  6. Scrambled egg on toast
bowl of oatmeal with strawberries in a bowl with milk

Do I Need to Change My Diet and Lifestyle?

The answer to this question depends largely on the results of your stress test. Were the results “normal” or “abnormal”? How are you currently living your life? What risk factors do you currently have that put you at risk for heart disease?

Many lifestyle and genetic factors play a role in your health. Diet is only a small part of following a heart-healthy lifestyle. Listen to what your doctor tells you and be honest with them about what changes you are willing to make to benefit your health. Start small and continue to make changes where needed.

Some areas in which you can make changes right now to support heart health include:

  • Eating more fruits, vegetables, nuts and beans
  • Getting 150 minutes of exercise each week
  • Getting 7-9 hours of sleep each night
  • Quit smoking and avoid secondhand smoke
  • Manage and reduce stress levels

>>For more information on the above areas, read my article “5 Things You Can Do to Support Heart Health NOW“. Or try some delicious heart-healthy recipes.

>>For more on heart-healthy diets: DASH Diet vs Mediterranean Diet: Which Is Best?

Conclusion

So, why can’t you eat before a stress test? The answer is, to reduce the chances of nausea during your stress test. However, it’s also good to know that sometimes you CAN eat before a stress test. It all depends on when your test is scheduled and the guidelines of the facility administering the test.

Some facilities suggest not eating anything starting at midnight on the day of testing while others allow a light meal up to 4 hours before your test. You will still need to avoid tobacco and caffeinated beverages for at least 24 hours.

Overall, a stress test is not something to stress about. You are in good hands with trained medical professionals. And knowing that you can stop the test at any moment should give you some peace of mind.

You now know what a stress test is, what it measures, along with some reasons that your doctor may want you to have one.

Each type of stress test is slightly different but one thing remains the same for them all:

  1. Your heart rate and vitals will be monitored for them all.
  2. Each test will give your doctor more information on how to treat and manage your condition.

Stress Test Prep Checklist

Check out this checklist for some reminders and to help prepare yourself.

Stress Test Prep Checklist

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