Stress Test

What is a stress test?

A stress test, also known as an exercise ECG, is a non-invasive test that assesses how well your heart handles physical activity by monitoring your heart rhythm, blood pressure and your heart’s overall response during exercise using an electrocardiogram (ECG).

What is the purpose of a stress test?

The purpose of a stress test is to check for any problems that occur when the heart is working hard. This may include issues with the heart’s blood supply, rhythm, or rate, along with other aspects of heart function, such as the thickness of the heart muscle (hypertrophy).

Heart conditions that may be detected during a stress test include:

• arrhythmias and other conditions that are related to an abnormal heart rhythm
• coronary artery disease (narrowed or blocked arteries in the heart)
• cardiomyopathy

When do I need a stress test?

A stress test is generally recommended if your doctor wants to investigate for any of the above heart conditions. A stress test might also be ordered in case of certain heart-related symptoms, which may include:

• palpitations
• chest pain
• shortness of breath
• fatigue
• dizziness
• fainting

Why do I need a stress test instead of a standard ECG?

As opposed to a standard ECG, which is done when the heart is at rest, a stress test shows how the heart performs when it is working hard.

For this reason, a stress test may be used to:

• reproduce symptoms that only occur during physical activity
• assess for potential blockages of the heart arteries (called coronary arteries)
• assess how well a treatment may be working
• determine a safe exercise plan
• identify whether a person is likely to be at risk of complications during surgery
• determine overall fitness

How is a stress test performed?

Small, sticky sensors (electrodes) are placed on the skin of the chest and abdomen. These sensors are connected by leads to the ECG machine, which continuously records the electrical activity of the heart.

A baseline recording will be taken. You will then walk on a treadmill or ride a stationary bike at an increasing pace and incline. Your heart will continue to pump harder and faster as the pace increases, which can help reveal any of the above issues.

For those who are unable to exercise, medications can be used to simulate the same conditions the heart would be under during physical activity.

How do I prepare for a stress test?

You may be required to avoid eating, smoking, and drinking alcohol or caffeine before the test. It is best to wear loose, comfortable clothing and walking shoes. As some medications may influence the results, you will need to discuss with your doctor whether it is OK to take your regular medication(s) before the test.

A stress test generally takes less than an hour, with around 15 minutes dedicated to the exercise portion of the test.

Are stress tests safe and are there any risks involved?

Stress tests are generally safe, and few people experience complications. The test is conducted by a health professional who can provide assistance should any symptoms occur during the test, including dizziness due to low blood pressure or symptoms caused by irregular heart rhythms.

Though very rare, it is possible for a stress test to cause a heart attack.

Who should not undergo a stress test?

Stress tests may not be appropriate for some people. This includes those who have:

• a high risk of complications
• advanced heart disease
• recent history of heart attack
• uncontrollable arrhythmia

What alternatives are available if I am concerned about doing a stress test?

Depending on exactly why your doctor or cardiologist wants to do the test, there may be several possible alternatives to a stress test. It is best to have a conversation with your doctor or cardiologist to discuss these options.