Exercise stress test
An exercise stress test is used to measure the effect of exercise on your heart.
How is the Test Performed?
This test is done at a medical center or health care provider's office.
The technician will place 10 flat, sticky patches called electrodes on your chest. These patches are attached to an ECG monitor that follows the electrical activity of your heart during the test.
You will walk on a treadmill or pedal on an exercise bicycle. Slowly (about every 3 minutes), you will be asked to walk (or pedal) faster and on an incline. It is like walking fast or jogging up a hill.
While you exercise, the activity of your heart is measured with an electrocardiogram (ECG). Your blood pressure readings are also taken.
The test continues until:
- You reach a target heart rate.
- You develop chest pain or a change in your blood pressure that is concerning.
- ECG changes suggest that your heart muscle is not getting enough oxygen.
- You are too tired or have other symptoms, such as leg pain, that keep you from continuing.
You will be monitored for 10 - 15 minutes after exercising, or until your heart rate returns to baseline. The total time of the test is around 60 minutes.
Preparation for the Test
Wear comfortable shoes and loose clothing to allow you to exercise.
Ask your health care provider if you should take any of your regular medicines on the day of the test. Some medicines may interfere with test results. Never stop taking any medicine without first talking to your doctor.
You must not eat, smoke, or drink beverages containing caffeine or alcohol for 3 hours (or more) before the test. In most cases, you will be asked to avoid caffeine for 24 hours before the test. This includes:
- Tea and coffee
- All sodas, even ones that are labeled caffeine-free
- Certain pain relievers that contain caffeine
How the Test will Feel
Electrodes (conductive patches) will be placed on your chest to record the heart's activity. The preparation of the electrode sites on your chest may produce a mild burning or stinging sensation.
The blood pressure cuff on your arm will be inflated every few minutes. This produces a squeezing sensation that may feel tight. Baseline measurements of heart rate and blood pressure will be taken before exercise starts.
You will start walking on a treadmill or pedaling a stationary bicycle. The pace and incline of the treadmill (or the pedaling resistance) will slowly be increased.
Sometimes, people experience some of the following symptoms during the test:
Why is the Test Performed?
Reasons why an exercise stress test may be performed include:
- You are having chest pain (to check for coronary artery disease -- narrowing of the arteries that feed the heart muscle).
- Your angina is getting worse or is happening more often.
- You have had a heart attack.
- You have had angioplasty or heart bypass surgery.
- You are going to start an exercise program and you have heart disease or certain risk factors, such as diabetes.
- To identify heart rhythm changes that may occur during exercise.
- To further test for a heart valve problem (such as aortic valve or mitral valve stenosis).
There may be other reasons why your health care provider asks for this test.
Normal Results for Exercise stress test
The meaning of your test results depends on the reason for the test, your age, and your history of heart and other medical problems.
It may be hard to interpret the results of an exercise-only stress test in some patients.
What Abnormal Results Mean
Abnormal results may be due to:
- Abnormal heart rhythms during exercise
- Changes in your ECG that may mean there is a blockage in the arteries that supply your heart (coronary artery disease)
When you have an abnormal exercise stress test, you may have other tests performed on your heart such as:
Exercise stress test Risks
Stress tests are generally safe. Some patients may have chest pain or may faint or collapse. A heart attack or dangerous irregular heart rhythm is rare.
People who are more likely to have such complications are often already known to have a weak heart, so they are not given this test.
Balady GJ, Morise AP. Exercise stress testing. In: Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 13.
Boden WE. Angina pectoris and stable ischemic heart disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 71.
Fihn SD, Gardin JM, Abrams J, et al. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation. 2012;126:e354-471.
Goff DC Jr, Lloyd-Jones DM, Bennett G, O'Donnell CJ, Coady S, Robinson J, et al. 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013; pii: S0735-1097(13)06031-2.
|Review Date: 8/12/2014
Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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Micromedex® Care Notes
- Acute Coronary Syndrome
- Chest Pain
- Chest Wall Pain
- Chest Wall Pain In Children
- Coronary Artery Disease
- Coronary Artery Disease In Women
- Heart Attack
- Noncardiac Chest Pain