Exercise stress test is an important diagnostic method that evaluates the heart’s performance during exercise. It is widely used in detecting coronary artery disease.
What is an Exercise Stress Test?#
An exercise stress test is the monitoring of the heart’s electrical activity (ECG) and blood pressure during gradually increasing exercise on a treadmill or bicycle ergometer.
Purpose of Exercise Stress Test:
- Coronary artery disease diagnosis
- Determination of exercise capacity
- Evaluation of treatment efficacy
- Risk stratification
Exercise Stress Test Indications#
Diagnostic Indications#
- Chest pain evaluation
- Suspected coronary artery disease
- Shortness of breath investigation
- Atypical symptoms
Prognostic Evaluation#
- Known coronary artery disease
- Post-myocardial infarction
- Post-revascularization
- Heart failure
Other Indications#
- Athlete screening
- Exercise prescription
- Heart valve disease evaluation
- Arrhythmia evaluation
Pre-Test Preparation#
General Preparation#
- Light meal up to 3 hours before
- Comfortable athletic clothing
- Athletic shoes
- Caffeine and smoking restriction
Medication Adjustment#
Some medications may be stopped before the test:
- Beta blockers (with doctor approval)
- Calcium channel blockers
- Nitrates
How is Exercise Stress Test Performed?#
Test Protocol#
Bruce Protocol (Most common):
- 3-minute stages
- Speed and incline increase each stage
- Attempt to reach maximum heart rate
Procedure Steps#
- Baseline ECG: Resting recording
- Blood pressure measurement: Baseline value
- Exercise start: Low speed
- Gradual increase: Every 3 minutes
- Maximum effort: Target heart rate
- Recovery: 5-10 minute monitoring
Test Duration#
Total duration: 15-30 minutes (exercise + recovery)
Exercise Stress Test Termination Criteria#
Absolute Criteria#
- Severe chest pain
- Significant ST depression (>2mm)
- Blood pressure drop
- Serious arrhythmia
- Patient request
Relative Criteria#
- Moderate chest pain
- Fatigue
- Shortness of breath
- Leg pain
- Hypertensive response
Exercise Stress Test Results#
Positive Test (Abnormal)#
| Finding | Meaning |
|---|---|
| ST depression ≥1mm | Ischemia |
| Chest pain | Angina |
| Blood pressure drop | Severe disease |
| Arrhythmia | Electrical instability |
Negative Test (Normal)#
- Target heart rate achieved
- No ST changes
- No symptoms
- Normal blood pressure response
Inconclusive Test#
- Target heart rate not achieved
- Uninterpretable ECG changes
- Additional testing may be needed
Exercise Stress Test Risks#
Risks are low but may include:
- Chest pain
- Arrhythmia
- Blood pressure changes
- Rarely myocardial infarction
Frequently Asked Questions#
Is exercise stress test dangerous?
How long does exercise stress test take?
Do I need to fast for exercise stress test?
When do exercise stress test results come out?
Can another test be done instead of exercise stress test?
Appointment and Contact#
If you would like to schedule an appointment for exercise stress test:
📍 Avrasya Hospital - Beştelsiz Mah. 101. Sokak No:107, Zeytinburnu, Istanbul
📞 Phone: +90 212 665 50 50 (Ext: 4012)
This content has been prepared by Assoc. Prof. Dr. Habib Çil for general informational purposes. Please consult a cardiology specialist for definitive diagnosis and treatment.
Related Diagnostic Tests#
Other diagnostic tests related to exercise stress test:
- Stress Echocardiography - Exercise echo
- Myocardial Perfusion - Myocardial perfusion scintigraphy
- EKG - Electrocardiography
- Cardiac CT - Computed tomography
- Coronary Artery Disease - About coronary artery disease