Exercise ECG (Stress Test)

Introduction

Exercise ECG, also known as a stress test or treadmill test, is a diagnostic tool used to assess heart function under physical exertion. It helps detect coronary artery disease (CAD), evaluate exercise tolerance, and monitor treatment effects in patients with cardiovascular conditions.

Why Is It Performed?

  • Detection of Coronary Artery Disease (CAD): Helps identify blockages in the coronary arteries by analyzing how the heart muscle responds to increased workload.
  • Assessment of Arrhythmias: Exercise can trigger ECG changes that reveal arrhythmias not seen at rest.
  • Evaluation of Exercise Tolerance: Determines how well the heart handles physical activity, useful for patients with heart conditions.
  • Monitoring of Treatment Efficacy: Helps assess the effectiveness of medications or treatments for heart disease.

How Is It Done?

  1. Electrodes are placed on the chest to record heart activity.
  2. The patient walks on a treadmill or uses a stationary bike with increasing intensity.
  3. Heart rate, blood pressure, and ECG are continuously monitored.
  4. The test ends when the patient reaches target heart rate, experiences symptoms, or shows ECG abnormalities.

Results Interpretation

  • Normal: Heart functions properly under stress.
  • Abnormal: Indications of ischemia (lack of blood flow), arrhythmias, or other cardiac conditions may require further testing (e.g., echocardiography, coronary angiography).

Risks and Contraindications

  • Generally safe but may provoke chest pain, dizziness, or arrhythmias.
  • Contraindicated in cases of severe aortic stenosis, uncontrolled hypertension, acute myocardial infarction, or unstable angina.

Conclusion

Exercise ECG is an important non-invasive test used in cardiology to evaluate heart health and guide treatment decisions. Always consult your cardiologist for personalized advice.

Source recommendations

1. American College of Cardiology/American Heart Association Guidelines for Exercise Testing

  1. https://pubmed.ncbi.nlm.nih.gov/9207652/
  2. https://www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adults
  3. https://www.ahajournals.org/doi/10.1161/01.cir.0000034670.06526.15
  4. https://www.jacc.org/doi/10.1016/S0735-1097%2802%2902164-2
  5. https://www.ahajournals.org/doi/10.1161/01.CIR.96.1.345

2. European Society of Cardiology Guidelines on the Management of Chronic Coronary Syndromes

  1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Chronic-Coronary-Syndromes
  2. https://academic.oup.com/eurheartj/article/45/36/3415/7743115
  3. https://pubmed.ncbi.nlm.nih.gov/31504439/
  4. https://academic.oup.com/eurheartj/article/41/3/407/5556137
  5. https://pubmed.ncbi.nlm.nih.gov/39210710/

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