Basic overview

• Stress testing is a type of functional test that involves patients using either a treadmill (most centres) or a recumbent bicycle in a pre-specified graded exercise protocol.
• The test is conducted with either ECG and blood pressure monitoring alone, or in conjunction with an echo (heart ultrasound) – the latter improves the diagnostic accuracy of the test.

Indications for the test

• Assessment for significant coronary artery disease
• Assessment of severity of valvular heart disease (in selected patients only)
• Assessment for exercise induced arrhythmias (heart rhythm disorders)
• Evaluation of breathlessness (i.e. suspected heart problem)

What to expect

• You will be connected to a set of electrodes (ECG dots) and a baseline ECG (heart trace) will be recorded. You will be asked to lay on a bed and a baseline resting ultrasound scan will be performed. Following this, you will be asked to walk on a treadmill beginning at 2.7 km/h, which slowly increases in speed and incline every 2 minutes until you reach your maximum level of exercise, develop ECG changes or symptoms that require you to stop (this can last 5-10 minutes, and younger patients may be required to jog). A repeat ultrasound of the heart will be performed as quickly as possible after exercise to examine your hearts response to exercise.