Johns Hopkins Health Alerts | Heart Health | Using an Exercise Stress Test to Diagnose Heart Disease

• A standard exercise stress test uses an electrocardiogram (ECG) to record the electrical impulses from the heart during exercise. The electrical signal often changes when the heart is not receiving enough blood and oxygen during physical activity.

In people who have chest pain or are at risk for coronary heart disease, an exercise stress test can be used to detect the presence of heart disease. The test may also be performed to assess the safety and appropriate level of exercise for people beginning an exercise program after a heart attack or bypass surgery and to evaluate the effectiveness of certain treatments (such as those for arrhythmias).

The stress test to detect heart disease involves walking on a treadmill or pedaling a stationary bicycle. The speed and incline of the treadmill or the resistance of the bicycle are gradually increased until the person reaches his or her target heart rate (at least 85% of maximal heart rate). The stress test may be stopped early if the person becomes fatigued or experiences symptoms such as chest pain, shortness of breath, dizziness, or an irregular heartbeat.

An exercise stress test is not always accurate in detecting the presence of coronary heart disease. In young women and other people at low risk for coronary heart disease, the stress test may be abnormal even though there is no significant heart disease.

The stress test is also associated with a very small risk of a heart attack or a dangerous heart rhythm, but patients are carefully monitored during the stress test and treated immediately if any serious complications occur.

Johns Hopkins Health Alerts | Heart Health | Using an Exercise Stress Test to Diagnose Heart Disease