As early as 1930 changes in the electrocardiogram were recognized as indicating decreased blood flow to the heart and producing the clinical condition of angina pectoris. Over the next 40 years, use of the electrocardiogram combined with graded exercise (on a stationary bicycle or on a treadmill) became the predominant noninvasive test using the assessment of patient’s with potential cardiovascular disease. Over the past 20 years myocardial perfusion imaging with radioisotopes and echocardiographic assessment of left ventricular function have been coupled with exercise to enhance detection of underlying coronary artery disease. In the moderate exercise laboratory 50% of tests are coupled with imaging modality. Radionuclide imaging following use of medications which either promote dilatation of the coronary arteries or produce increased heart rate and blood pressure, allow assessment of coronary artery disease and potential heart muscle dysfunction in individuals would otherwise be unable to exercise.
At Hartford Hospital five fully equipped and staffed exercise labs are located within the section of noninvasive testing which includes echocardiography and nuclear cardiology. One lab is dedicated to research in exercise physiology. A second lab is used primarily with echocardiographic imaging of the heart under exercise conditions. In the remaining three labs approximately 15-20 examination are performed on a daily basis combining exercise electrocardiography with cardiac imaging using radioisotopes. All stress tests are supervised by a cardiologist.