This test is also known as an exercise stress test or an exercise tolerance test.
An exercise ECG is an electrocardiogram (ECG) that is recorded while you are walking on a treadmill or cycling on an exercise bike. The idea of this test is to see how your heart works whilst you are moving about or exercising when your heart has to work harder. The heart needs more blood and oxygen when you are active. An exercise ECG can show if your heart muscle is receiving enough blood.
Several small sticky patches (electrodes) are put on your chest. These are connected, by wires, to an ECG machine to record all the electrical activity of your heart, in the same way as for the ECG described above. You will then be asked to exercise, either by walking on a treadmill or cycling on an exercise bike. The test starts off at a very easy rate and is gradually made harder. Your ECG reading, blood
pressure and pulse will be monitored throughout the test. The test will be stopped when certain targets have been reached. The test would also be stopped if you started to get symptoms such as chest pain, chest tightness, shortness of breath, tiredness, blood pressure that is too high or too low, or an abnormal heart rhythm. Or if you felt you could not carry on with the test.
You will then be monitored for a period of recovery following the test.
The exercise test usually lasts between approximately 2 minutes and 15 minutes. It can be hard work, but should not be too much for you. Like many people, you may be pleasantly surprised by how much you can achieve. The value of the test is much greater if you try to work as hard as you can.
The test can help doctors find out if you have coronary heart disease. If, during the test, there are certain changes in the ECG pattern, or if you develop symptoms such as chest pain or chest tightness, or if there are abnormal changes in your blood pressure or heart rate, this may mean that there is narrowing of the coronary arteries and that you may need further tests.
If you already know you have coronary heart disease, an exercise ECG gives information about how severe your condition might be. For example, it can give some idea of how much strain your narrowed coronary arteries are under when you exercise. This can help your doctors to assess if your condition has got worse, and help them plan the best treatment for you.
An exercise ECG also helps doctors to see how well your heart is working if you have recently had heart surgery, coronary angioplasty / Stent, or a heart attack and can help doctors decide what level of exercise you should do as part of a cardiac rehabilitation programme.
This test can also be used if you have been collapsing or having blackouts, particularly if this happens while you are being active or exercising.
If you have coronary heart disease, an exercise ECG can show ‘ischaemic changes’ during exercise. This means that the test is showing that there is a reduced supply of oxygen to the heart muscle. If you get chest pain and there are ischaemic changes on the ECG recording at the same time, this could mean that the chest pain is coming from your heart.
The exercise ECG test may show changes that suggest coronary heart disease, even though the person has very few or no symptoms.
An exercise ECG is a very useful test. It is widely available and it’s a very safe test compared to many other medical tests. Most people find that the test is not unpleasant or distressing.