This test is done at a medical center or health care provider's office.
The technician will place 10 flat, sticky patches called electrodes on your chest. These are attached to an ECG monitor that follows the electrical activity of your heart during the test.
You will walk on a treadmill or pedal on an exercise bicycle. Slowly (usually every 3 minutes), you will be asked to walk (or pedal) faster and on an incline. It is like walking fast or jogging up a hill.
While you exercise, the activity of your heart is measured with an electrocardiogram (ECG), and your blood pressure readings are taken.
You develop chest pain or a change in your blood pressure that is concerning
ECG changes show that your heart muscle is not getting enough oxygen
You are too tired or have other symptoms, such as leg pain, that keep you from continuing
You will be monitored for 10 - 15 minutes after exercising, or until your heart rate returns to baseline. The total time of the test is around 60 minutes.
How to prepare for the test
You must not eat, smoke, or drink beverages containing caffeine or alcohol for 3 hours (or more) before the test.
Wear comfortable shoes and loose clothing to allow you to exercise.
Ask your health care provider if you should take any of your regular medicines on the day of the test. Some medicines may interfere with test results. Never stop taking any medicine without first talking to your doctor.
Tell your doctor if you are taking sildenafil citrate (Viagra), tadalafil (Cialis), or vardenafil (Levitra) and have taken a dose within the past 24 to 48 hours.
You will usually be asked to avoid caffeine for 24 hours before the test. This includes:
Tea and coffee
All sodas, even ones that are labeled caffeine-free
Certain pain relievers that contain caffeine
How the test will feel
Electrodes (conductive patches) will be placed on your chest to record the heart's activity. The preparation of the electrode sites on your chest may produce a mild burning or stinging sensation.
The blood pressure cuff on your arm will be inflated every few minutes, producing a squeezing sensation that may feel tight. Baseline measurements of heart rate and blood pressure will be taken before exercise starts.
You will start walking on a treadmill or pedaling a stationary bicycle. The pace and incline of the treadmill (or the pedaling resistance) will slowly be increased.
Sometimes, people experience some of the following during the test:
Chaitman BR. Exercise stress testing. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsevier;2011:chap 14.
Fraker TD Jr, Fihn SD, Gibbons RJ, Abrams J, Chatterjee K, Daley J, et al. 2007 chronic angina focused update of the ACC/AHA 2002 Guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Writing Group to develop the focused update of the 2002 Guidelines for the management of patients with chronic stable angina. Circulation. 2007;116:2762-2772.
David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.