An exercise stress test is one of the simplest and fastest procedures used to evaluate the heart and its response to stress or exercise. Electrodes (small, plastic patches) are placed at certain locations on the chest, arms, and legs. When the electrodes are connected to an ECG machine by lead wires, the electrical activity of the heart is measured, interpreted, and printed out for the physician's information and further interpretation. During this test, the ECG is monitored while a person is exercising on a treadmill. An ECG tracing will be taken at certain points during the test in order to compare the effects of increasing stress on the heart. Periodically, the incline and treadmill speed will be increased in order to make exercise more difficult for the person being tested. The person will exercise until reaching a target heart rate (determined by the physician based on age and physical status) or until unable to continue due to fatigue, shortness of breath, chest pain, or other symptoms.
Before Your Exercise Stress Test
- Your physician may instruct you to stop or taper certain medications before your stress test. You should check with your physician if any medications should be stopped before this test.
- When you arrive for the test, a physician or a technician will explain the procedure to you and offer you the opportunity to ask any questions that you might have about the procedure.
- You will be asked to fast for a few hours before the procedure. You should not smoke for two hours prior to the procedure.
- If you are pregnant or suspect that you may be pregnant, you should notify your physician.
- Notify the physician of all medications (prescription and over-the-counter) and herbal supplements that you are taking.
- Notify the physician if you have a pacemaker or defibrillator.
- Wear flat shoes with rubber soles or sneakers that are comfortable for walking and loose-fitting pants or shorts. Women should wear a short-sleeved top that fastens in the front for ease of attaching the ECG electrodes to the chest.
- The area(s) where the electrodes are to be placed may be shaved.
- Based upon your medical condition, your physician may request other specific preparation.
An exercise ECG may be performed on an outpatient basis or as part of your stay in a hospital. Procedures may vary depending on your condition and your physician's practices. Generally, an exercise ECG follows this process:
- You will be asked to remove any jewelry or other objects that may interfere with the procedure.
- You will be asked to open your blouse or shirt in the front (men may be asked to remove their shirts). The technician will ensure your privacy by covering you with a sheet or gown and exposing only the necessary skin.
- If your chest, arms, or legs are very hairy, the technician may shave small patches of hairas needed so that the electrodes will stick closely to the skin.
- The technician will lightly abrade your skin where the electrodes are to be place and then clean these areas with alcohol. Electrodes will then be attached to your chest, arms, and legs.
- The lead wires will be attached to the skin electrodes.
- Once the leads are attached, the technician may enter into the computer identifying information about you.
- A blood pressure cuff will be attached to your arm while you are sitting down. Initial, or baseline, ECG and blood pressure readings will be taken while you are lyingsitting down and standing up. A baseline blood pressure reading will be taken while you are standing up.
- You will be instructed on how to walk on the treadmill. Alternately, you may exercise on a bicycle. You will be told to let the technician, physician, or nurse know if you begin to have any chest pain, dizziness, lightheadedness, extreme shortness of breath, nausea, headache, leg pains, or other symptoms during exercise.
- You will begin to exercise at a minimal level. The intensity of the exercise will be gradually increased on the treadmill by increasing the incline and speed of the treadmill every few minutes.
- ECG and blood pressure readings will be taken periodically during the exercise to measure how well your heart and body are responding to the exercise.
- The exercise will end once you have reached a target heart rate (determined by the physician based on your age and physical condition). The test may also be stopped if you develop severe symptoms such as chest pain, dizziness, nausea, severe shortness of breath, severe fatigue, or an abnormalelevated blood pressure or for abnormal findings on the ECG.
- Once you have reached your target heart rate, the rate of exercise will be slowed for a "cool down" period to help avoid any nausea or cramping from sudden stopping of exercise.
- You will sit in a chair and your ECG and blood pressure will be monitored until they return to normal or near-normal. This may take 10 to 20 minutes.
- Once your ECG and blood pressure readings are acceptable to the physician, the ECG electrodes and blood pressure cuff will be removed. You may then put on your shirt or blouse.
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- You should be able to resume your normal diet and activities, unless your physician instructs you differently.
- Generally, there is no special care following an exercise ECG.
- You may feel tired for several hours or longer after the procedure, particularly if you do not normally exercise. Otherwise, you should feel normal within a few hours after the procedure, if not sooner. If your fatigue lasts longer than a day, you should notify your physician.
- Notify your physician if you develop any signs or symptoms you had prior to the test (e.g., chest pain, shortness of breath, dizziness, or fainting).
- Your physician may give you additional or alternate instructions after the procedure, depending on your particular situation.
Contact
Cardiac Graphics Laboratory
Starr 4, Cardiovascular Center
520 East 70th Street
New York, NY 10021
Telephone: (212) 746-4670
Fax: (212) 746-8701
