Exercise Stress Testing
Electrocardiography (ECG) is a test done to record the electrical activity of the heart.
Exercise electrocardiography or Exercise Stress Testing is an ECG done during exercise. This will allow us to see how your heart responds to the demands of physical activity.
During exercise the heart muscle needs blood in its arteries to pump. Areas where one or more of these arteries are blocked will struggle with exercise and this will show up on the ECG.
An exercise stress test is a specific test performed to assess the heart's response to exercise and detect various forms of heart disease.
The aim of the test is to measure the heart's activity at rest and while walking. This enables the cardiologist to detect various abnormalities of the heart. It is generally a safe and painless procedure.
Exercise stress testing is done to evaluate
- Chest pain - ie to determine its cause
- Identify abnormal heart rhythms like palpitations
- It can be used as a screen for patients with cardiac risk factors like high blood pressure, high cholesterol, family history
- Your exercise capacity with known heart disease
- A safe level of exercise in patient's with heart disease
- The effectiveness of stents or bypass surgery
- The future risk of heart related conditions
An exercise stress test may not be performed on patients who
- Are having a heart attack
- Have unstable angina
- Have very high blood pressure
- Severe valvular abnormalities like aortic stenosis
- Have an abnormal rhythm called bundle branch block which makes the ECG uninterpretable
- Have severe lung disease
- Have mobility problems which will stop them from exercising
- Any other non-cardiac disorders that can be aggravated by exercise
Before the test
- Do not eat for 4 hours before the test (you may drink water)
- Continue taking your medications unless your doctor has specified otherwise
- Either wear or bring comfortable clothes and shoes to walk in
- Let the testing Doctor know if you have used Viagra within the last 24hrs
Informed Consent
It is a requirement by law that we receive your consent to do your test. It is important that you understand what the test is about, how it is done and what the risks are. You will be given a form which will outline these things. If you have any questions please feel free to ask either the technician or testing doctor who will be in the room with you when you sign the form.
How the test is done
Small sticky pads called electrodes are stuck to your skin to detect the ECG. To do this the technician will need a bare chest. Ladies will be given a gown.
The electrodes need to have good contact with your skin to pick up the electrical impulses from down in your heart. Men with hairy chests will be shaven in spots for the electrodes to be placed. The technician will give your skin a little scrub with rough paper and then a wipe with alcohol. This removes the dead skin cells which form a barrier. You will find that this may sting a little and it will leave red patches on your skin. This is normal and will take a couple of days to go away. Some patients with extra sensitive skin may develop small blisters from the gel used on the electrodes. This is rare and will heal quickly.
With the electrodes and leads attached to your chest you will then have to walk on the treadmill. This can be tricky at first but the speed is very slow for the first 3 minutes to give you time to get used to it. Every 3 minutes the treadmill will get slightly faster and steeper. If you are fit you may get to the stage where you will have to run.
During exercise it is important that you tell the staff if you feel any symptoms. The test will end when you have gone as long as you can, ideally when your heart rate has increased and you are feeling puffed.
After the exercise you will be monitored while your heart rate returns to rest. You can then dress and see the cardiologist for the results.
The test will take about 1 hour
Overall
The test is a good measure of the patient's heart condition. Ithowevere has certain limitations and is not 100% accurate. The results can be affected by
- Abnormal resting ECG
- Anxiety/panic/inability to complete the test
- Failure to reach a maximum heart rate
Possible adverse events related to stress testing includes but is not limited to
- Lightheadedness
- Tiredness, fatigue
- Leg cramps
- Shortness of breath
- Chest pain
- Heart attack
- Collapse
- Arrhythmia
- Death
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