Exercise Stress ECG

What is an Exercise Stress ECG?

An exercise stress ECG is a test that records the heart's electrical activity (ECG) while the patient exercises, typically on a treadmill or stationary bike. It evaluates how the heart responds to physical stress, helping diagnose coronary artery disease, assess exercise tolerance, and evaluate symptoms like chest pain or shortness of breath.

How Does an Exercise Stress ECG Work?

During an exercise stress ECG, electrodes are placed on the chest to record the heart's electrical activity. The patient exercises on a treadmill or bike, starting at a low intensity and gradually increasing in difficulty. The ECG is continuously monitored, and blood pressure is measured at regular intervals.

What Does an Exercise Stress ECG Measure?

An exercise stress ECG measures:

• Heart Rate Response: How heart rate increases with exercise.

• ECG Changes: Looks for ST-segment changes indicating ischemia (reduced blood flow to the heart).

• Blood Pressure Response: Monitors blood pressure changes during exercise.

• Exercise Tolerance: Assesses how long the patient can exercise and their overall fitness level.

• Symptoms: Evaluates if symptoms like chest pain occur during exercise.

What Can an Exercise Stress ECG Diagnose?

An exercise stress ECG can help diagnose:

• Coronary Artery Disease (CAD): Detects reduced blood flow to the heart muscle.

• Exercise-Induced Arrhythmias: Abnormal heart rhythms triggered by exercise.

• Exercise Tolerance: Evaluates overall cardiovascular fitness.

• Cause of Symptoms: Helps determine if symptoms like chest pain are related to heart disease.

Preparing for an Exercise Stress ECG

Preparing for an exercise stress ECG:

• Wear Comfortable Clothing: Wear comfortable clothes and shoes suitable for exercise.

• Avoid Heavy Meals: Avoid eating a large meal before the test.

• Medication Discussion: Discuss any medications with your doctor, as some may need to be adjusted before the test.

What to Expect During an Exercise Stress ECG

During an exercise stress ECG:

• Exercise Protocol: Exercise intensity increases gradually according to a protocol (e.g., Bruce protocol).

• Monitoring: ECG and blood pressure are continuously monitored.

• Stopping Criteria: The test may be stopped if symptoms, significant ECG changes, or abnormal blood pressure responses occur.

• Recovery Phase: After exercise, a recovery ECG is often recorded.

Benefits of an Exercise Stress ECG

Benefits of an exercise stress ECG include:

• Non-Invasive: A relatively non-invasive test.

• Diagnostic Value: Helps diagnose coronary artery disease and other heart conditions.

• Prognostic Information: Provides information on prognosis and risk stratification.

Risks and Limitations

• False Results: Like any test, there's a chance of false positives or negatives.

• Limited Sensitivity: May not detect all cases of coronary artery disease.

• Requires Exercise Ability: Patients must be able to exercise.

Analyzing Exercise Stress ECG Results

• Cardiologist Review: Results are reviewed by a cardiologist.

• Report Generation: A report detailing findings, including ECG changes, exercise tolerance, and symptoms.