Exercise (or stress) ECG

Some heart problems only show when the heart is working harder. An exercise ECG, also called a stress test, records your heart while you walk on a treadmill, to see whether the heart muscle is getting enough blood from the coronary arteries. It is often used to look for coronary artery disease and to investigate:

• chest pain that comes on with exertion, which may be angina
• breathlessness with activity
• palpitations or dizziness

It can also be used after a procedure such as a coronary angioplasty, to check the blood flow to the heart.

• Wear light, comfortable clothes and trainers or other shoes you can walk briskly in.
• Avoid a heavy meal, and drinks with caffeine, for two to three hours beforehand.
• Do not smoke for eight hours before the test.
• You may be asked to stop some medicines beforehand. Only stop a medicine if you have been told to.

Sticky pads are placed on your chest and shoulders and connected to the ECG machine, and a cuff on your arm measures your blood pressure. You start walking slowly on the treadmill. In stages it becomes steeper and faster, so that your heart gradually works harder.

Staff watch your ECG, heart rate and blood pressure the whole time and ask how you feel. Tell them straight away if you have chest pain or discomfort, feel dizzy, very tired or very short of breath. The test stops once enough information has been gathered, if symptoms develop, or whenever you feel unable to carry on. You will not be asked to do anything that feels too difficult for you.

Afterwards you rest until your heart rate and breathing have settled, and then you can go home.

Yes, for the people it is chosen for. Your history and symptoms are checked first to make sure the test suits you, it is supervised throughout, and it is stopped promptly if there are worrying symptoms or ECG changes. Serious complications are rare.

A normal result does not rule out every kind of heart disease, as some narrowing of the arteries does not show clearly on an exercise ECG. If you cannot walk on a treadmill, or more detail is needed, other tests such as a CT coronary angiogram or a stress echocardiogram may be suggested instead.