Exercise Stress Test

An exercise stress test, also known as a treadmill test or exercise electrocardiogram, is a diagnostic procedure used to assess the heart's function under physical stress.

Purpose

The primary purpose of an exercise stress test is to:

• Evaluate the heart's ability to function during physical activity
• Diagnose and monitor conditions such as coronary artery disease, heart failure, and arrhythmias
• Determine the effectiveness of treatment for existing heart conditions
• Assess cardiovascular risk in asymptomatic individuals

Procedure

The exercise stress test typically involves the following steps:

1. The patient is asked to remove clothing from the waist up and change into a gown or comfortable clothing
2. Electrodes are attached to the patient's chest, arms, and legs to record the heart's electrical activity (ECG)
3. A blood pressure cuff is placed on the patient's arm to monitor blood pressure during the test
4. The patient walks on a treadmill or uses a stationary bike, with the intensity of the exercise gradually increasing over time
5. The ECG and blood pressure are continuously monitored during the test, which typically lasts between 7-12 minutes
6. The patient may be asked to report any symptoms, such as chest pain or shortness of breath, during the test

Types of Exercise Stress Tests

There are several types of exercise stress tests, including:

• Treadmill test: The most common type of exercise stress test, which involves walking on a treadmill
• Stationary bike test: An alternative to the treadmill test, which involves pedaling a stationary bike
• Arm ergometry test: A test that involves using a device to measure the patient's arm strength and endurance

Risks and Contraindications

While exercise stress tests are generally safe, there are some risks and contraindications to consider:

• Risks: Chest pain, shortness of breath, dizziness, and arrhythmias
• Contraindications: Recent heart attack, unstable angina, severe hypertension, and certain types of heart failure

Interpretation of Results

The results of an exercise stress test are interpreted by a healthcare professional, who will look for:

• ECG changes: Abnormalities in the heart's electrical activity, such as ST-segment depression or elevation
• Blood pressure response: An abnormal increase or decrease in blood pressure during exercise
• Symptoms: The presence or absence of symptoms, such as chest pain or shortness of breath, during the test

Follow-up Care

After an exercise stress test, the patient may be:

• Referred for further testing, such as a nuclear stress test or cardiac catheterization
• Started on medication to manage symptoms or treat underlying conditions
• Advised to make lifestyle changes, such as increasing physical activity or quitting smoking