Failing a stress test occurs when you cannot complete it due to exhaustion or other factors. Abnormal results may indicate an underlying health condition that requires further evaluation.

A stress test, also known as an exercise stress test or treadmill test, is a diagnostic procedure to evaluate the heart’s function under stress, typically during exercise.

During the test, a medical professional will ask you to walk or run on a treadmill or ride a stationary bike while they monitor your heart rate, blood pressure, and other vital signs on an electrocardiogram (EKG) machine.

Failing and “abnormal” results are two components of a stress test. A negative result, meanwhile, means no abnormalities were detected.

Keep reading to learn more about abnormal stress test results and what they may indicate for your heart health.

Failing a stress test means you cannot reach or sustain the target heart rate during the exercise portion of the test. This may be due to physical limitations, like joint pain, breathing difficulties, or underlying heart conditions like coronary artery disease.

In this case, the professional administrating the test may recommend a chemical stress test. During this test, they will intravenously administer a chemical medication like adenosine, stimulating your heart’s response to exercise and allowing doctors to evaluate its function.

During a stress test, your test administrator monitors several vital signs to evaluate how well your heart functions during physical activity, including:

  • heart rate
  • blood pressure
  • heart rhythm
  • any symptoms you experience during the test, such as chest pain, shortness of breath, or dizziness

Abnormal stress test results can suggest an underlying heart condition, like coronary artery disease, that may require further testing or treatment.

In some cases, these test results may also suggest a blockage in the arteries supplying blood to your heart, increasing your risk of a heart attack.

What is considered a ’’normal‘‘ or negative result?

A stress test is considered normal or negative if your heart rate, blood pressure, and heart rhythm are within a healthy range and you have no signs of reduced blood flow to the heart muscle or other indications of an underlying heart condition.

The next step after an abnormal stress test depends on the specific detected abnormalities and your medical history. Your doctor may order additional tests like a coronary angiogram if they suspect blocked arteries to determine the extent and location of the blockages.

During a coronary angiogram, a special dye is injected into the blood vessels, and X-rays are taken to create a detailed image of the coronary arteries.

If the stress test abnormalities are due to other factors, such as an irregular heartbeat, further tests may be necessary to evaluate the underlying cause, including:

  • Echocardiogram: This noninvasive test uses sound waves to create images of your heart. An echocardiogram can help doctors evaluate the structure and function of your heart and identify any abnormalities.
  • Cardiac CT or MRI: These imaging tests can provide detailed images of your heart and blood vessels, helping doctors evaluate blood flow and identify any blockages or other abnormalities.

Based on the results of these additional tests, your doctor may recommend medication, lifestyle changes, or further procedures to address any underlying conditions affecting your heart function.

A doctor may order a stress test if you are at risk for or have symptoms of heart disease.

Signs and symptoms may include:

Having a family history of heart disease or other risk factors for heart disease may also prompt your doctor to order an exercise stress test.

They may also order a stress test if you are considering vigorous physical activity that may strain your heart or undergoing heart treatment.

The following are some frequently asked questions about abnormal stress test results:

Can a stress test show a blockage?

Yes, cardiac stress tests are typically sensitive in detecting blockages obstructing 70% or more of the heart’s arteries that supply blood to the heart muscles, known as coronary arteries. A blockage is a narrowing or obstruction of the coronary arteries, usually due to the buildup of cholesterol plaque, known as atherosclerosis.

What happens if doctors find a blockage during a stress test?

If a stress test indicates that there may be a blockage in the coronary arteries, your doctor may need to order more tests, such as a coronary angiogram, to confirm the diagnosis.

Can you have an abnormal stress test result but no blockage?

Yes, it’s possible to have an abnormal stress test result even if there is no blockage in the coronary arteries. There are several reasons why this may occur, such as if you are taking certain medications like beta-blockers.

Stress tests commonly evaluate the heart’s function and diagnose underlying heart conditions. An abnormal stress test result can indicate an underlying health condition like coronary artery disease that may require further evaluation.

While an abnormal stress test result can be concerning, it doesn’t necessarily mean that there is a significant problem with your heart. Depending on your specific circumstances, your doctor may need to order more tests, such as a coronary angiogram, to diagnose the underlying cause of the abnormal result.