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Exercise Stress Test

An exercise stress test, also known as a treadmill test or exercise ECG, is a medical test that evaluates the heart's response to exercise. During the test, the patient walks on a treadmill or pedals a stationary bike while hooked up to an electrocardiogram (ECG) machine. The test gradually increases the intensity of the exercise to measure the heart's ability to respond to stress.

The length of time an exercise stress test takes can vary, but typically it takes about 30-60 minutes to complete. The actual exercise portion of the test usually lasts for about 5-15 minutes.

Most people do not experience pain during an exercise stress test. However, some people may experience fatigue, shortness of breath or chest discomfort.

If you cannot walk, this is not a test you will be able to complete.

If you have chest pain during the test, it is stopped.

Nitroglycerine spray is always available to treat chest pain.

If you have chest pain and changes on your EKG, or go into a dangerous heart rhythm, sometimes you are sent to the ER or for Cardiac Cath.

Sometimes, this is done AFTER a heart attack to see how much exercise is safe for you to do in Cardiac Rehabilitation. 

Sometimes, Exercise Stress Tests can be normal, but there is underlying cardiac disease. 

Sometimes, Exercise Stress Tests can be highly suggestive of heart disease, but none is there. 

Common diagnoses made by an exercise stress test include:

  • Coronary artery disease, which can cause a reduced blood flow to the heart during exercise

  • Abnormal heart rhythms, such as atrial fibrillation or ventricular tachycardia

  • Heart valve problems, which can affect the heart's ability to pump blood efficiently

  • Poor physical fitness, which can increase the risk of future heart problems

  • Lung problems, such as asthma or chronic obstructive pulmonary disease (COPD), which can limit exercise capacity.

This test is not for you if: 

  • You have a coronary artery disease diagnosis, have undergone treatment and not had new symptoms for years and are doing well on medical therapy.

  • No history of risk factors for coronary artery disease or coronary disease or symptoms.

  • A low risk of heart disease, including people who do not smoke, are physically active and eat a heart-healthy diet.

Your doctor will determine if you meet these criteria or not.


The test is also not for people with certain heart conditions: 


Before the test:

  • No eating  in the hours leading up to the test. If you’re having a nuclear stress test, you might not be able to eat until after your test.

  • Avoid caffeine for 24 hours before testing. This includes coffee, tea, energy drinks and certain over-the-counter medications.

  • Not smoke or use tobacco products.

  • You MIGHT be advised to stop certain prescription medications the day of your test: beta-blockers (i.e. metoprolol, carvedilol) and asthma inhalers (Albuterol, Ventolin).

  • Wear lightweight, comfortable clothes and sturdy walking shoes.

Here is a great video to explain: Cardiac Stress Test: Exercise

See the printable handout for more information: What is a Stress Test

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