Exercise Stress Test

Written by Brian Krans | Published on June 20, 2012
Medically Reviewed by George Krucik, MD

What Is an Exercise Stress Test?

An exercise stress test is used to determine how well your heart responds during times when it is working the hardest.

During the test, you will be asked to exercise—typically on a treadmill—while you are hooked up to an electrocardiogram (EKG). This allows your doctor to monitor your heart rate.

The exercise stress test is also referred to as an exercise test or treadmill test.

Why an Exercise Stress Test Is Done

An exercise stress test is primarily used to help determine if your heart receives an adequate amount of oxygen and a proper blood flow when it needs it most, such as when you are exercising.

It can be ordered for people who have been experiencing chest pains and other symptoms of coronary heart disease.

The Harvard Medical School states that stress tests are among the best tools not only for diagnosing heart disease, but also for estimating the risk of disease in people who have risk factors, like high cholesterol (Harvard Medical School) .

An exercise stress test may also be used to determine a person’s level of health, especially if he or she is starting a new exercise program. This allows a doctor to know what level of exercise a person is capable of handling safely.

If you are a smoker over 40 years old or if you have other risk factors for heart disease, you should talk to your doctor to see if an exercise stress test is a good idea for you.

The Risks of an Exercise Stress Test

Stress tests are generally considered safe, especially since they are done in a controlled environment under the supervision of a trained medical professional.

However, there are some rare risks, such as:

  • chest pain
  • collapsing
  • fainting
  • heart attack
  • irregular heartbeat

However, these reactions are particularly uncommon with this test since your doctor will screen you for problems beforehand. People who run the risk of these complications—such as those with advanced coronary heart disease—are rarely asked to do the test.

How to Prepare for an Exercise Stress Test

Prior to your test, your doctor will perform a physical exam and ask about your complete medical history. At this point, you should tell your doctor about your symptoms, especially any chest pains or shortness of breath.

You should also tell your doctor about any conditions or symptoms that may make exercising difficult, such as if you have stiff joints from arthritis.

Finally, you should let your doctor know if you have diabetes, because exercise affects blood sugar. If you do have diabetes, your doctor may want to monitor your blood glucose levels during the exercise test as well.

The day of the test, be sure to dress in loose, comfortable clothing. Something that is light and breathable is best. Make sure to wear comfortable shoes, such as athletic sneakers.

Your doctor will give you complete instructions about how best to prepare. These might include:

  • not eating, smoking, or drinking caffeinated beverages for three hours before the test
  • stopping certain medications (only do this if you are specifically instructed by your doctor)
  • reporting any chest pains or other complications on the day of the test

How an Exercise Stress Test Is Performed

Before you begin exercising, you’ll be hooked up to the EKG. Several sticky pads will be attached to your skin under your clothes. Your doctor or a nurse will check your heart rate and breathing before you begin exercising.

Your doctor may also have you breathe into a tube to test the strength of your lungs.

You’ll start off by walking slowly on a treadmill. The speed and grade of the treadmill will be increased as the test continues.

If you experience any difficulties, specifically chest pains, weakness, or fatigue, you may ask to stop the test.

When your doctor is satisfied with your results, you’ll be able to stop exercising. Your heart rate and breathing will continue to be monitored for a short while afterward.

Following Up After an Exercise Stress Test

After the test, you’ll be asked to rest and given water. If your blood pressure rises during the test, your attending nurse may continue to monitor your blood pressure.

A few days following the test, your doctor will review the results with you. It could reveal irregular heart rhythms or other symptoms that indicate coronary artery disease, such as blocked arteries.

If the test determines you may have coronary artery disease or other heart problems, your doctor may begin treatments or order more tests, such as a nuclear stress test.

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