Adenosine Stress Test

Instructor: Justine Fritzel

Justine has been a Registered Nurse for 10 years and has a Bachelor's of Science in Nursing degree.

Stress tests are done to evaluate the function of the heart while exercising. If a person is unable to tolerate exercise for the test, the doctor will do an adenosine stress test instead. In this lesson, we will learn about the adenosine stress test.

Heart Disease

Our heart works endlessly yet we rarely think about all that it does. In an average lifetime, the heart beats approximately 2.5 billion times. It never gets to stop to take a break and serves as the life support for our bodies. Everything we do throughout the day, physically or emotionally, impacts our heart health, sometimes for the better (sleep, exercise, meditation) and sometimes for the worse (stress, unhealthy food).

Heart disease is the leading cause of death in the United States for both men and women. Based on statistics, one person in the United States dies every 34 seconds because of heart disease. There are ways to predict and prevent this fatal disease. In this lesson, we will look at one of these ways, called an adenosine stress test.

Stress Test

Let's meet Sylvia. She is a 56-year-old female working in a high-stress job. She is obese and has high blood pressure. Her mother died at age 50 with heart disease, so it runs in her family. Her family history, coupled with her strenuous job and unhealthy lifestyle make her a likely candidate for heart disease. Her doctor has told her that she needs to eat better and lose weight, but she is too stressed to figure out how to do that. Recently, she started feeling more fatigued, and she even had some chest pain the other day at work. She told her doctor about it, and he said she needed to have a stress test to evaluate the function of her heart.

In order for Sylvia to complete a stress test, she would need to go to her doctor's office. Her doctor would have her on a treadmill while monitoring her blood pressure and heart rate. Sylvia would have patches on her chest for an electrocardiogram (EKG), which would measure the activity of her heart. Her doctor would gradually increase the speed of the treadmill to evaluate how her heart responds to the increased demand from activity.

Stress Test
Stress Test

Sylvia tells her doctor that there is no way she can walk on the treadmill. She has significant pain in her knees and generally uses an electric scooter to get around for any distance. He explains to her that there is another way to do the test without using the treadmill. She can have an adenosine stress test.

Adenosine Stress Test

Adenosine is a prescription medication that is given directly into the vein through an IV. It is classified as an antiarryhthmic drug which is used to treat abnormal heart rates in emergency situations. Adenosine is also used for stress tests when a person is unable to tolerate walking on the treadmill.


Adenosine works by dilating the coronary arteries. The coronary arteries carry oxygen and nutrient rich blood to the heart muscle. When the arteries are dilated, there is increased blood flow. When a person exercises, the coronary arteries dilate and have increased blood flow to meet the demands of the increased work of the heart. Using adenosine mimics what happens during exercise, so the doctor is able to evaluate the function of Sylvia's heart even if she can't walk on the treadmill.

Sylvia is scheduled for her adenosine stress test in a few days. Her doctor instructs her to have nothing to eat or drink the day of the test. She also has to avoid caffeine for 24 hours prior to the test.

When the day of the test arrives, she goes to the hospital's imaging lab. The nurse administers IVs for the adenosine and contrast dye. The nurse tells Sylvia that she needs to lie as still as possible in the MRI machine so they can get pictures of her heart. The MRI captures images of Sylvia's heart size and is able to see how the blood is flowing through the coronary arteries.

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