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Exercise Stress Test


An exercise stress test is used to measure the effect of exercise on your heart.


How the Test is Performed

The technician will place 10 flat, sticky patches called electrodes on your chest. These are attached to an ECG monitor that follows the electrical activity of your heart during the test.

You will walk on a treadmill.

  • About every 3 minutes you will be asked to walk (or pedal) faster.

  • You will also have to walk on a steeper angle. This is like walking fast or jogging up a hill.

While you exercise, the activity of your heart is measured with an electrocardiogram (ECG). Your blood pressure readings are also taken.

The test continues until:

  • You reach a target heart rate.

  • You develop chest pain or a change in your blood pressure that is concerning.

  • ECG changes show that your heart muscle is not getting enough oxygen.

  • Your heart rhythm changes.

  • You are too tired or have other symptoms, such as leg pain, that keep you from continuing.

You will be monitored for 10 to 15 minutes after exercising, or until your heart rate returns to baseline. The total time of the test is around 60 minutes.


How to Prepare for the Test

You must not eat, smoke, or drink beverages containing caffeine or alcohol for 3 hours (or more) before the test.

Wear comfortable shoes and loose clothing to allow you to exercise.

Some medicines may interfere with test results and we will discuss whether you should stop any of these prior to taking the test.

Tell your doctor if you are taking sildenafil citrate (Viagra), tadalafil (Cialis), or vardenafil (Levitra) and have taken a dose within the past 24 to 48 hours.

You will usually be asked to avoid caffeine for 24 hours before the test. This includes:

  • Tea and coffee

  • All sodas, even ones that are labeled caffeine-free

  • Chocolates

  • Certain pain relievers that contain caffeine


How the Test Will Feel

Electrodes (conductive patches) will be placed on your chest to record the heart's activity. You may feel mild burning or stinging when the electrode sites are prepared.

You will have a blood pressure cuff on your arm that will be inflated every few minutes. This will produce a tight, squeezing feeling.

Baseline measurements of heart rate and blood pressure will be taken before exercise starts.

Sometimes, people experience some of the following during the test:

  • Chest discomfort

  • Dizziness

  • Palpitations

  • Shortness of breath


Why the Test is Performed

Reasons why you may have an exercise stress test include:

  • You are having chest pain and the test is done to check for narrowing of the arteries.

  • Your angina is becoming more severe or is happening more often.

  • You have had a heart attack.

  • You have had angioplasty or heart bypass surgery.

  • You are going to start an exercise program and you have heart disease or risk factors, such as diabetes

  • Your health care provider needs to look for heart rhythm changes that may occur during exercise.

  • You need further testing for heart valve problem (such as aortic valve or mitral valve stenosis).

There may be other reasons why your health care provider asks for this test.


Normal Results

The meaning of your test results depends on the reason for the test, your age, and your history of heart and other medical problems.

It may be hard to interpret the results of an exercise-only stress test in some patients.


What Abnormal Results Mean

Abnormal results may be due to:

  • Abnormal heart rhythms during exercise

  • Changes in your ECG that may mean there is a blockage in the arteries that supply your heart (coronary artery disease)

When you have an abnormal exercise stress test, you may have other tests performed on your heart such as:

  • Cardiac catheterisation 

  • Nuclear stress test

  • Stress echocardiography



Stress tests are mostly safe. Some patients may have chest pain or may faint or collapse. A heart attack or dangerous irregular rhythm is rare.

Complications are more likely in people who are already known to have a weak heart. This test is not given in these cases.