Exercise ECG (or stress test)
 

What is an Exercise ECG?
An Exercise ECG is a frequently performed test which is used to diagnose a wide range of heart conditions, including coronary artery disease and exercise induced abnormalities of heart rhythm. It is often also used to monitor a patient’s health status after a heart attack and after patients have been treated for coronary artery disease with coronary stents or bypass surgery.

The test involves recording the heart’s electrical activity (ECG) and also the patient’s blood pressure at rest, and then at regular intervals whilst the patient exercises on a treadmill. Changes in the ECG appearance induced by increasing the work the heart does as a result of exercise can indicate the presence of heart disease. Similarly the development of chest pain or other symptoms with exercise, and also an abnormal BP change with exercise can also indicate the presence heart disease. 
 
 
Preparing for an Exercise ECG?

• There is no special preparation, just come in comfortable clothing and footwear.
• It is advisable to wear a two piece outfit for the test.
• You might like to bring a small towel.
• Please do not use cream or talc on your chest area on the day of the test.
• There is no need to fast before the test, however, have only a light breakfast or lunch immediately prior to your Exercise EGC.
• Please bring a list of your medications and any referral letter
• If you are on beta-blocker medication, please discuss with your referring doctor whether it would be appropriate to cease this for one or two days prior to the test.
• Please do not exercise prior to the test on the day of your Exercise ECG.

What is involved?

• As with a resting ECG, electrodes which are connected to an ECG machine are applied to the chest.
• Ladies wear their bra and will be given a gown to wear while exercising. Men may need small areas of their chest shaved to ensure good electrode contact.
• The nurse will use very fine medical sandpaper to gently roughen the skin where the electrodes are applied to ensure good adhesion. Alcohol will then be applied to prepare the skin where the electrodes will be placed. The alcohol may feel cold
• A belt that houses the electrode leads will be placed around the waist. This connects to the ECG machine.
• A BP cuff will be placed on the arm, to monitor blood pressure throughout the test.
• The test is performed by walking on a motorized treadmill. It is not difficult, and the treadmill starts at a very slow pace.
• Every three minutes the speed and slope of the treadmill increases marginally.
• Exercise time depends on how you are feeling. The objective is to exercise to a level that gets your heart rate up to 85% of your predicated rate (which is based on age), but the test will be terminated before that time if you feel tired, uncomfortable or have other concerns.
• It is important to mention any discomfort experienced.
• There is a cool-down phase after exercise while your heart returns to its resting rate.

Does it hurt?
The procedure is totally painless and risks are minimal. Some patients may find the test demanding, but if you are not coping, the treadmill will be stopped immediately. The electrodes may sometimes leave red marks. These will fade away in a few days time.