Dear doctor;

I have heard that stress tests can be done? Is that so? How would one do a stress test like at home?

Joanne, 31, Kigali.

Dear Joanne,

Stress test is usually done to confirm the presence of angina in individuals complaining of suspicious chest pain. Chest pain on the left side can occur for many reasons like dyspepsia, muscular pains and also angina (where blood vessels to heart are blocked due to fat deposition and  circulation to the heart is reduced for few seconds after exertion causing chest pain). Treatment of angina is different from other conditions and untreated it is potentially fatal condition. Hence it is imperative to diagnose it in doubtful cases.

In older days stress test was done by step test, where the individual was made to step up and down over fixed number of steps. Nowadays computerised stress test machines (tread mill) are available, where the person is made to move on a conveyer belt connected to a cardiac monitor, the electrodes being fixed on the chest. The speed and inclination of the belt is increased at fixed intervals. If one is able to run up to his target heart rate, depending on the height and age, angina is unlikely. If a person develops breathlessness, chest pain, among others symptoms of angina, the test is aborted immediately. It is not possible to do a technical stress test at home. But if somebody has recently started having chest pain, breathlessness, palpitations and sweating after mild to moderate exertion, they should be screened for angina. Electrocardiogram, done during chest pain, also aids in diagnosis. Risk factors for angina like hypertension, diabetes, family history of cardiovascular disease, obesity, stress and use of alcohol and tobacco should be vigilant about it.