Harvard Heart Letter

Ask the doctor: Is a nuclear imaging stress test the same thing as an exercise stress test or exercise echocardiogram?

Ask the doctor

Is a nuclear imaging stress test the same thing as an exercise stress test or exercise echocardiogram?

Q. I had some vague chest pain on vacation and went to the emergency room. The doctor told me to have a nuclear imaging stress test when I got home. My primary care physician sent me to a cardiologist for a treadmill test. But the cardiologist had me do an exercise echocardiogram on a bicycle. Are these tests the same? Why is everyone telling me that I need a different test?

A. These are all different tests, each with its own pluses and minuses. The nuclear imaging test can take hours and requires injecting a small dose of a radioactive tracer into the bloodstream to measure blood flow. The standard treadmill test is fast, easy, and inexpensive, but it relies on changes in the electrocardiogram to make a diagnosis, so it isn't that helpful in people who already have abnormal electrocardiograms. The exercise echocardiogram, which can be done on a treadmill or bicycle, takes pictures of the heart before, after, and sometimes during exercise.

Each of these tests offers essentially the same thing: additional objective information to help your doctor decide if your chest pain is coming from your heart. Doctors often have heated arguments about which test is best. The truth is, they provide similar information, although in some circumstances, one test can be more useful than another.

To continue reading this article, you must login.
  • Research health conditions
  • Check your symptoms
  • Prepare for a doctor's visit or test
  • Find the best treatments and procedures for you
  • Explore options for better nutrition and exercise
Learn more about the many benefits and features of joining Harvard Health Online »