Exercise electrocardiogram (stress test)

An exercise electrocardiogram (EKG or ECG) is a test that checks for changes in your heart while you exercise. Sometimes your doctor can only see heart problems during exercise or while you have symptoms.

This test is sometimes called an exercise EKG, stress test, or treadmill test.

An exercise electrocardiogram is done to:

• Help find the cause of unexplained chest pain or pressure.
• Help decide on the best treatment for a person with angina.
• See how well people who have had a heart attack or heart surgery are able to tolerate exercise.
• Help find the cause of symptoms that occur during exercise or activity, such as dizziness; fainting; or rapid, irregular heartbeats (palpitations).
• Check for a blockage or narrowing of an artery after a medical procedure, such as angioplasty or coronary artery bypass surgery, especially if the person has chest pain or other symptoms.
• See how well medicine or other treatment for angina or an irregular heartbeat is working.
• Help you make decisions about starting an exercise program if you have been inactive for a number of years and have an increased chance of having heart disease.

You most likely will either walk on a treadmill or pedal a stationary bicycle.

You will have a blood pressure cuff on your upper arm. Small pads or patches (electrodes) will be placed, like stickers, on your skin on each arm and leg and on your chest. Your doctor may wrap your chest with an elastic band to keep the electrodes from falling off.

On the treadmill, you will start out slowly in a level or slightly inclined position. After certain periods of time, the speed and steepness of the treadmill will be increased so that you will be walking faster and at a greater incline.

On the stationary bicycle, you will pedal fast enough to keep a certain speed. After certain periods of time, the resistance will be increased, making it harder to pedal.

In both tests:

• Your EKG, heart rate, and blood pressure are recorded.
• You might be asked to use numbers to say how hard you are exercising. The higher the number, the harder you think you are exercising.
• The test will continue until:
  • You need to stop.
  • You have reached a target heart rate.
  • You have angina symptoms, such as chest pain or pressure.
  • You are very tired or very short of breath.
  • Your doctor feels you need to stop because of a change in your heartbeat or blood pressure.

After the test, you will be able to sit or lie down and rest. Your EKG and blood pressure will be checked for about 5 to 10 minutes.

• Do not smoke or eat a heavy meal before this test.
• Wear flat, comfortable shoes (no bedroom slippers) and loose, lightweight shorts or sweatpants. Walking or running shoes are best.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your test. Your doctor will tell you if you should stop taking any of them before the test and how soon to do it.

Your doctor may be able to talk to you about your results right after the test. But complete test results may take several days.

Your doctor will look at the pattern of spikes and dips on your EKG to check the electrical activity in different parts of your heart. The spikes and dips are grouped into different sections that show how your heart is working.

Some people who have a normal exercise EKG may still have heart disease. And some people with an abnormal test don't have heart disease.