Women's Health Matters

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Tests To Help Identify Risk Factors

To reduce the chance of dying from a heart attack, it is important to find the heart disease early and start treatment. Many studies have found that women are less likely to be tested for heart disease than men.

If you experience the signs and symptoms of a stroke, call 9-1-1 immediately. Diagnosing and treating a stroke as early as possible is crucial. It is important to call even if your symptoms have disappeared. A stroke should be diagnosed and treated within the first three hours.

To identify risk factors for a stroke or to diagnose a stroke, your doctor will conduct a number of tests.

Exercise/Stress Tests

An exercise test (sometimes referred to as a “stress test”) is a simple test that your family physician or cardiologist may recommend, to evaluate your heart health. This test can help identify the cause of unexplained chest pain and check for some types of heart disease.

You will be asked to walk (not run) on a treadmill or pedal a stationary bicycle, while hooked up to an electrocardiogram (ECG), which can measure the electrical activity of your heart and see how your heart responds to exercise. Your heart rate and blood pressure will also be taken.

You will be asked not to eat or drink anything for about three to four hours before the test. It is important that you wear comfortable walking shoes and loose clothing. Before the test, the ECG pads will be taped to areas on your chest and you will be connected to the ECG monitor. Your heart rhythm will be watched closely throughout the test. Your blood pressure and ECG will be taken while you sit, stand and lie down, as well as while you are walking on the treadmill or pedaling. If you are using a treadmill for your stress test, the treadmill will increase in speed and slant about every three minutes. You will usually be asked to walk for as long as possible, until you are tired or develop any symptoms. If you are using a stationary bicycle, the resistance will be increased gradually, making it increasingly challenging to pedal. The test continues until you reach your maximum heart rate or until you need to stop.

The entire test usually lasts for 15 to 30 minutes. After exercising, you will be able to rest, either sitting or lying down, while your ECG and blood pressure are monitored.

Non-Invasive Imaging

To assess whether you have coronary artery disease, your doctor may recommend further testing, using non-invasive imaging techniques. Non-invasive techniques are procedures that do not involve surgery or penetration of the body with examining devices. Non-invasive imaging can be done either with low and safe amounts of radiation or with echocardiography (cardiac ultrasound).

These imaging tests are usually done in conjunction with an exercise test or with medication that simulates exercise for patients who are unable to exercise.

These tests are very safe and provide the most comprehensive information possible without using an invasive procedure.


Angiography is an invasive test used to diagnose advanced heart disease. For an angiography test, dye is injected into the coronary arteries to find blockages. In the past, women were less likely than men to receive angiography. Dr. Leonard Sternberg, Chief of Cardiology at Women's College Hospital, says: "Hopefully, more recent awareness of the prevalence of heart disease among women and of how women’s symptoms and responses can be different from those of men will avoid any gender bias in treatment.”

Angiography is also known as cardiac catheterization. This test allows your doctor to look at the heart's chambers, valves and blood vessels. A long, thin tube, called a catheter, is placed in a blood vessel and guided to the heart. A "dye" is injected and x-rays showing the dye's path are taken. These x-rays are then examined for blockages in the coronary arteries and to see how well the heart is working.

Some routine blood tests are usually required before the angiography. The day of the procedure, you will be asked to have only a light breakfast and to take most of your heart medications. Medication to help you relax can be given during the test.

The procedure will be performed by a specially trained team consisting of a cardiologist, a nurse and an x-ray technician. The groin or wrist area will be cleaned and anesthetized and a tiny incision will be made. The doctor will then insert the catheter up to the heart using x-ray guidance. A dye will be injected and a feeling of warmth or flushing might occur. The whole procedure lasts about 60 minutes.

After the procedure, the catheter is removed and pressure is applied to the groin or wrist site. You will then go to a recovery area for observation. To prevent any bleeding or excessive bruising at the insertion site, it is important to lie flat with your leg straight for the first four hours following the procedure. The procedure is usually done on an outpatient basis and you can go home the same day.


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  • A publication of:
  • Women's College Hospital