Stress Test

A stress test, also called an exercise stress test, is used to gather information about how well your heart works during physical activity. Because exercise makes your heart pump harder and faster, an exercise stress test can reveal problems within your heart that might not be noticeable otherwise.

An exercise stress test involves walking on a treadmill while your heart rhythm, blood pressure and breathing are monitored.

Your doctor may recommend an exercise stress test if he or she suspects you have coronary artery disease. An exercise stress test may also be used to guide your treatment if you’ve already been diagnosed with a heart condition.

Why it’s done:
Your doctor may recommend an exercise stress test to:

  • Diagnose coronary artery disease.
    Your coronary arteries are the major blood vessels that supply your heart with blood, oxygen and nutrients. Coronary artery disease is a condition that develops when these arteries become damaged or diseased – usually due to a buildup of deposits containing cholesterol called plaque. If you have symptoms such as shortness of breath or chest pains with exertion, an exercise stress test can help determine if they’re related to coronary artery disease.
  • Diagnose heart rhythm problems (arrhythmias).
    Heart arrhythmia occur when the electrical impulses that coordinate your heart rhythm don’t function properly, causing your heart to beat too fast, too slow or irregularly. If you have symptoms such as a racing heartbeat or a fluttering in your chest, an exercise stress test can help determine if they’re related to an arrhythmia.

An exercise stress test is generally safe and complications are rare. But, as with any medical procedure, it does carry a risk of complications. Potential complications include:

  • Low blood pressure. Exercise can result in low blood pressure that makes you feel dizzy or faint.
  • Abnormal heart rhythms (arrhythmias). Arrhythmias brought on by an exercise stress test usually go away shortly after you stop exercising.
  • Heart attack (myocardial infarction). Although very rare, it’s possible that an exercise stress test could cause a heart attack.

You may be asked not to eat, drink or smoke for four to six hours before the stress test. You can take your medications as usual, unless your doctor tells you otherwise.

If you use an inhaler for asthma or other breathing problems, bring it with you to the test. Make sure your doctor and the health care team member monitoring your stress test know that you use an inhaler. Wear or bring comfortable clothes and walking shoes with you to the exercise stress test.

Read complete instructions on preparing for your stress test here.

What you can expect:
When you arrive for your exercise stress test, your doctor will ask you about your medical history and how often you typically exercise. This helps determine the total time needed to exercise during the stress test.

During an exercise stress test:
Before you start the test, a member of your health care team places sticky patches (electrodes) on your chest, legs and arms. The electrodes are connected by wires do an electrocardiogram (ECG or EKG) machine. The electrocardiogram records the electrical signals that trigger your heartbeats. A blood pressure cuff is placed on your arm to check your blood pressure during the exercise stress test.

You then begin slowly walking on the treadmill. As the test progresses, the speed and incline of the treadmill increases.

The length of the test depends on your physical fitness and symptoms. The goal is to have your heart work hard for about six to ten minutes. You continue exercising until your heart rate has reached a set target, or until you develop symptoms that don’t allow you to continue. These signs and symptoms may include:

  • Moderate to severe chest pain
  • Severe shortness of breath
  • Abnormally high or low blood pressure
  • An abnormal heart rhythm
  • Dizziness

After an exercise stress test:
After you stop exercising, you may be asked to stand still for several seconds and then lie down for about five minutes with the monitors in places that they can continue taking measurements as your heart rate and breathing return to normal.

When you exercise stress test is complete, you may return to your normal activities for the remainder of the day.

Your physician will discuss the findings at the conclusion of the exam.