Exercise Treadmill Test (Stress Test)

An exercise stress test, often simply referred to as a stress test, is a non-invasive diagnostic procedure designed to evaluate how well your heart responds to increased physical demand.

During the test, you’ll walk on a treadmill while your heart activity is continuously monitored. As the test progresses, the exercise will become more strenuous, typically through increasing the treadmill’s speed and incline. Throughout the test, electrodes attached to your chest will capture an electrocardiogram (ECG) to measure your heart’s electrical activity, while a blood pressure cuff tracks your blood pressure and you may be asked about any symptoms you’re experiencing.

The primary aim of an exercise stress test is to identify signs of ischaemia, a condition where the heart muscle doesn’t receive enough oxygen due to blocked or narrowed coronary arteries. When the heart works harder during exercise, it requires more oxygen. If the coronary arteries are narrowed or blocked, the heart may show signs of strain, which can be detected on the ECG. Symptoms like chest discomfort, shortness of breath, or dizziness can also become pronounced during the test.

Besides ischaemia, the test can reveal exercise-induced arrhythmias, which are irregular fast heart rhythms that become apparent only during physical exertion.

Furthermore, for individuals suspected of having a genetic arrhythmia disorder, an exercise stress test can sometimes bring out concealed ECG markers that are not evident at rest. For instance, conditions like catecholaminergic polymorphic ventricular tachycardia (CPVT) or long QT syndrome (LQTS) might have specific ECG changes that become pronounced with exercise. By pushing the heart to work harder, the stress test can uncover hidden electrical abnormalities, aiding in the diagnosis of these potentially dangerous conditions.