A stress test can help doctors diagnose certain heart conditions, but it’s a good idea to consider ages when deciding who might undergo this exercise-based screening.

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A nuclear stress test shows how well blood travels through the heart during exertion and rest. It‘s a helpful screening tool for doctors who suspect coronary artery disease (CAD).

Because this test requires a person to receive a small amount of radioactive dye in the blood vessels and to perform physical activity, it may not be the safest option for some older adults.

But for many older adults, a nuclear stress test may be safe and appropriate. When a doctor orders a nuclear stress test, they generally assess the person’s overall health and ability to perform the activities necessary for the test.

Learn more about nuclear stress tests.

Available research shows that nuclear stress testing, or myocardial perfusion imaging, may be a safe and useful tool for diagnosing coronary artery disease (CAD) in older adults. For example, a 2018 study suggested that nuclear stress testing may be safe for individuals 75 years and older who’ve experienced hospitalization for suspected CAD.

A nuclear stress test is a screening doctors carefully supervise and use to help them diagnose CAD. Your doctor can determine the level of physical activity, also called “stress,” to put you through based on your age and overall health, and they can reduce it to consider your age.

As people get older, the risk of CAD increases steadily. Nuclear stress testing can be very helpful in diagnosing CAD and predicting the outcome for someone with a heart condition.

A small 2020 study showed that for people 85 years and older, a nuclear stress test before heart surgery can be especially beneficial in predicting who might have a higher risk of major adverse events, such as heart failure or an arrhythmia.

Though experts generally consider it a safe screening, a nuclear stress test may come with some potential risks. Among them is the onset of an arrhythmia, which is a heart rhythm that’s too fast, too slow, chaotic, or unpredictable. Usually, a test-induced arrhythmia may go away once you stop exercising.

If there’s a significant blockage in the heart, a stress test can cause chest pain, dizziness, or lightheadedness. The test could trigger a heart attack, but that’s very rare.

An allergic reaction to the radioactive dye is also rare. In case of adverse reactions, the test usually occurs in a doctor’s office with health professionals ready to stop the test or assist you if necessary.

A doctor must evaluate an older adult to determine whether conditions such as frailty or difficulty exercising might make an exercise stress test unsafe. You may receive medication to stress the heart instead of exercise in these situations.

Your doctor may also consider whether your risk of CAD is high enough to warrant a nuclear stress test. If you have a low risk, your doctor may recommend other heart health assessments, such as standard exercise stress tests, regular physical exams, or incorporating lifestyle changes like eating a balanced diet and exercising regularly.

There are several precautions to take before, during, and after a nuclear stress test. For example, avoid consuming caffeine at least 24 hours before the test so that the results accurately reflect your heart’s usual functioning. Other precautions to take include the following:

  • Fast a few hours before the test. Check with your doctor for specific fasting guidance.
  • Wear comfortable clothing and walking or running shoes.
  • Avoid smoking before the test.
  • Get specific advice about your medications. You may need to pause taking drugs such as beta-blockers, for example, until after the test.

You may receive a radioactive liquid called a tracer through an intravenous line shortly before exercising. A healthcare professional can also place electrodes on various body parts. The electrodes attach to an electrocardiograph, which records the heart’s electrical activity.

About 20 minutes after receiving the tracer, you can lie under the “gamma camera,” which healthcare professionals use to take images of your heart at rest. After they take several images, you can get up and walk on a treadmill or ride a stationary bike. They may periodically increase the intensity level.

They can stop the exercise if you have symptoms or grow tired to continue. If you can keep exercising, they may ask you to stop once you reach your target heart level. The exercise lasts 10 to 15 minutes. You may receive more tracers at the exercising peak, and they may take more camera images.

Healthcare professionals may often break up the testing into two sessions, taking the resting images on one day and conducting the exercise portion on a different day. For convenience, many people choose to have both tests in one appointment. The entire process can take 3 or 4 hours.

The results from a nuclear stress test are usually available during and immediately after the test. Healthcare professionals may send them to your primary care doctor or cardiologist if those physicians aren’t present for the screening.

Who should not get a nuclear stress test?

If you have no symptoms of heart conditions and have a low risk of a heart attack, you may not need a nuclear stress test. Though using a radioactive tracer is generally safe, it’s not without some risk. Experts recommend that people unlikely to receive a CAD diagnosis avoid exposing themselves to that risk.

Should an 80-year-old have a stress test?

There are no age-specific guidelines that rule out anyone from a nuclear stress test. If the person’s doctor believes that the test might be helpful and that the person is also healthy enough to have the test, then 80 may be an appropriate age for a stress test.

Is radiation from a nuclear stress test harmful to others?

The small amount of radioactive material involved in a nuclear stress test usually poses no threat to people around the person undergoing the test. However, in an abundance of caution, experts may advise people who’ve received radioactive tracers to stay away from babies and young children for a day or two until the material exits the body.

Doctors widely use nuclear stress tests to screen for CAD, and it’s generally safe for older adults. If your doctor recommends the test, they can tell you why they consider it appropriate for you and the possible risks.