The Harvard Medical School Family Health Guide
Diagnostic Tests - Exercise Stress Test
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What happens when the test is performed?

 

  • First you have an EKG both while lying down and standing up. Your blood pressure is taken. Several plasticcoated wires, or leads, are taped to your arms and one leg so that your heart's electrical pattern can be detected while you exercise.Your blood pressure and heart rate also are monitored during the test. You are asked to walk on a treadmill for about 10 minutes. The speed and steepness of the treadmill will increase several times while you exercise. Let the person who is monitoring you know immediately if you feel chest pain or heaviness, shortness of breath, leg pain or weakness, or other unusual symptoms, or if you think you can't continue exercising.After the exercise period is completed, your blood pressure will be checked again.

    A variation of this test uses a radionuclide to visualize parts of the heart that are not getting enough blood. This test is called either an exercise-thallium test or exercise-MIBI test (depending on the radionuclides used). If you have this test, you will probably need to repeat it on a day when you have not been exercising hard, for the sake of comparison.

    An exercise stress test strongly suggests coronary artery disease if walking on the treadmill produces symptoms such as chest discomfort, shortness of breath, or dizziness, and these symptoms are accompanied by EKG changes that indicate inadequate blood flow to parts of the heart. A test is considered normal if you can perform a normal amount of exercise without symptoms or EKG changes. Many people have chest discomfort but no EKG changes, or vice versa. In these cases, the exercise test is of less help, and the result will be interpreted as consistent with coronary artery disease, but not conclusive. Further testing may then be required.

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