Exercise stress test

In general, this test is carried out to pinpoint the exact cause of unexplained chest pain, especially when coronary artery disease is suspected. If you have already been diagnosed with coronary artery disease, you may be offered an exercise ECG to determine how far the disease has progressed and to assess how much physical activity you can safely do. If you have had a heart attack or open-heart surgery, this test can help determine how much exertion or physical activity you can safely undertake. The test may also be recommended if you have irregular heartbeats (arrhythmias), a very fast heartbeat (tachycardia) or a very slow heartbeat (bradycardia), palpitations (an unusual pounding or fluttering of the heart), dizziness or excessive fatigue.

Wear clothes and shoes that are comfortable for physical activity. You will probably be asked not to smoke or eat for two hours before the test. Tell your doctor about all the medicines you are taking.

An exercise ECG is usually performed in a clinic or hospital. You will be asked to walk on a treadmill (or sometimes pedal on an exercise bike). Small metal electrodes will be attached to your chest and you will start walking (or pedalling) at a gentle pace. While you walk, the cardiologist will monitor your heart activity and heart rate, your breathing and your blood pressure. The speed of the treadmill will be gradually increased and you will have to walk faster. This allows the doctor to see how your heart adapts to increasing levels of exertion.

The test continues until your heart is beating as fast as it safely can (until you reach your maximum exercise capacity for your age and state of health), or until you experience chest pain. This test is generally safe, although it can trigger chest pain or arrhythmias. Be sure to tell someone about any discomfort or other symptoms you may feel. An exercise ECG can last between 15 and 30 minutes.