An exercise stress test involves recording an electrocardiogram (ECG) whilst exercising. It can be used to investigate for the presence of coronary artery disease and also evaluate exercise capacity.

IN PREPARATION

You will be advised to either continue your usual medication or to stop certain medication for 1-2 full days before the test.

You should eat no more than a light meal beforehand, but avoid tea and coffee (unless decaffeinated) and also avoid alcohol and smoking before attending for the test. Insulin treated diabetics may need to take additional carbohydrate or reduce their insulin to prevent hypoglycaemia after the test.

You should wear loose comfortable clothing and appropriate secure flat footwear (ladies should not wear 'long line' or 'all in one' under garments). You should also have with you any medication that you are taking.

You should inform the staff performing the test if there has been any change in your symptoms since you were last seen.

HOW IS IT DONE?

The physiologist will apply sticky disc type electrodes, to your chest, having rubbed the skin first so as to make a very good contact with the electrode (some gentlemen may need the electrode sites shaved first).  Then you will be connected to a heart monitor.  A blood pressure cuff is attached to your arm.  The physiologist will take an ECG recording and note your blood pressure reading before the exercise is started.

THE EXERCISE

This is usually done on a treadmill, which has a small ramp that has a wide moving belt on which you will walk.  There is a handrail for balance.  The speed and slope of the treadmill will be increased gradually, usually every 3 minutes and recordings of your blood pressure and heart tracing will be made at the end of each stage. The exercise will be stopped if your symptoms make this necessary or if  any abnormality in your ECG or blood pressure is noticed.

Recordings are also made at regular intervals after the exercise programme is complete, until pre exercise levels of heart rate and blood pressure are restored. For some patients an exercise bike may be used rather than a treadmill.

IS THERE ANY RISK?

Since the test involves stressing the heart, there is a very small risk of causing a change in rhythm of the heart or exceedingly rarely a heart attack. However, even in patients who have recently experienced a heart attack, the chance of a serious problem occurring during a test is only one in a thousand. You will be carefully observed during the test and treatment will be available should a complication occur.

WHY IS AN EXERCISE TEST USEFUL?

An exercise test can give detailed information about the heart during exercise. This is commonly useful for evaluating the cause of chest pain. It can provide information about the blood flow in the coronary arteries which cannot be detected on the ordinary resting ECG.  It can also demonstrate exercise capacity. This is an excellent, relatively inexpensive way of non-invasively investigating for the presence of coronary artery disease.

Home    Investigation and Management    Sudden Death in Athletes    Contact    Prof John Somauroo