Exercise test – what is it and when to use it

An exercise test is an electrocardiographic test that allows you to assess the physical capacity of the body and diagnose the causes of pain in the chest area. Exercise testing helps determine if a patient has ischemic heart disease. It also allows you to assess the condition of a patient who has suffered a heart attack.

What is an exercise test?

During the stress test, the patient exercises on a stationary bike or on a treadmill. During exercise, the patient’s heart and circulatory system is monitored with an electrocardiograph – the patient has electrodes stuck to his chest, just like when an ECG is hit.

During the exercise test, the patient has to exercise more and more stress on the heart and circulatory system – the pace is gradually increased. The EKG graph shows how your heart works during this increased effort.

When you exercise, your body has an increased oxygen demand, which causes the blood to circulate faster through the vessels that supply oxygen to the heart muscle. In patients with circulatory insufficiency in the coronary arteries, the heart cannot keep pumping blood during strenuous exercise, which causes symptoms of myocardial hypoxia.

How are the parameters of an exercise test assessed?

During the exercise test the patient’s physical effort is expressed in power units (Watt) if the patient has ridden an exercise bike or MET metabolic units if the patient has walked on a treadmill. One MET is 3,5 ml / kg bw / min and corresponds to resting oxygen consumption.

When is an exercise test used?

Stress testing is relatively simple and non-invasive, so it is often used to diagnose heart failure as a possible cause of chest pain and after a heart attack to assess the patient’s condition and prognosis.

A doctor often orders an exercise test when he suspects coronary artery disease, i.e. poor blood supply to the heart caused by atherosclerotic stenosis of the coronary arteries, in patients suffering from unstable coronary disease, in patients with aortic insufficiency or with atrioventricular heart block and in patients with with an implanted pacemaker to evaluate the functioning of this device.

How to prepare for a stress test?

The exercise test is a non-invasive test that does not require any special preparations. The patient undresses to the waist. Electrodes are attached to his chest as in a regular ECG examination. Then the patient starts exercising on a treadmill or stationary bike. During exercise, an ECG is made to show any abnormalities in the work of the heart muscle.

Then, a resting ECG is performed at 1, 3, 6 and 9 minutes after the patient has finished exercising on a treadmill or stationary bike.

The patient should not eat or smoke anything for 3 hours before the examination. Physical exertion should be avoided 12 hours before the examination.

How long does an exercise test take?

The exercise test lasts, depending on the patient’s condition, from several to several minutes.

The stress test is terminated if there is a drop in systolic blood pressure, chest pain, ECG changes, dyspnoea, difficulty in monitoring ECG and pressure during the test, skin bruising, pallor, dizziness, increasing chest pain unusual for angina , leg cramps, fatigue, anxiety and palpitations. The stress test can also be stopped at the patient’s request.

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