Exercise Stress Testing

About the Procedure

An Exercise Stress Test is a procedure to obtain information on the heart's ability to function under the stress of exercise. A physician may request a stress test to diagnose coronary artery disease (the narrowing of arteries in the heart due to plaque build-up) in patients who are considered at risk, or to evaluate the effectiveness of heart surgery or a medication regimen. A stress test is recommended when women over age 50 and men over age 40 plan to begin an exercise program. When a patient has recovered from a heart attack or has had angioplasty, they are often enrolled in a cardiac rehabilitation program and a stress test can help identify safe levels of exercise. The results appear as peaks and valleys on a strip or page of graph paper printed from an ECG machine.

Although procedures may vary from lab to lab, an exercise stress test is performed by a technician and is completed in one hour. In preparation for the test, ECG (electrocardiogram) wires are connected to electrodes are attached to the patient's chest, arms, and one leg with small, adhesive-coated pads; and a blood pressure cuff is put on their arm. The patient is asked to walk on a treadmill, or pedal a stationary bicycle, which starts slowly and increases in speed and incline until the pre-determined target heart rate is reached or the patient is unable to continue for physical reasons. Once the exercise is complete, the patient is monitored until all vital signs are normal. Variations of the exercise stress test include the exercise echocardiogram and a nuclear stress test.

What to Know Before the Procedure

Dangerous complications during a stress test are very rare. Some less severe complications are chest pain, fainting, dizziness, shortness of breath, or irregular heart beats. Prior to recommending a stress test, the physician assesses the patient's level of risk to avoid such complications.

To prepare for an exercise stress test the doctor will order blood tests and a resting ECG. Food and drink restrictions will be explained and medications will be reviewed to avoid interference with test results. Patients with diabetes may need to adjust their insulin on the day of the procedure. The physician should be advised if the patient has had any chest pain or heaviness on the day of the test.

What to Know After the Procedure

Immediately after the procedure, patients are monitored until all vital signs have returned to normal. They may drive themselves but having someone else with them may be reassuring.

The test results will be sent to the doctor within a few days. The doctor will contact the patient about the results and discuss treatment plans and/or medication adjustments, if necessary.

If you Need to Travel Outside of your Local Hospital

Exercise stress tests are performed frequently with minimal risk. Traveling for this procedure would not be restricted by post-test discomfort or limits to activities. Due to the nature and commonality of exercise stress testing, long-distance or international travel may be unnecessary when having this done as a stand alone procedure. However, it may be necessary in conjunction with other procedures where international travel is more viable.