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EXERCISE STRESS TEST (EXERCISE ECG TEST)
About the test
An exercise stress test is a non-invasive cardiac diagnostic test that assesses how the heart works during exercise, when the heart muscle’s demand for oxygen increases. The exercise stress test is performed on a treadmill or an exercise bike known as a cycle ergometer. During the test, the incline of the treadmill is gradually increased or, when using a cycle ergometer, the resistance is increased while maintaining a constant pedalling speed, making the heart work harder. Throughout the exercise stress test, heart rate and rhythm, blood pressure and ECG are continuously monitored.
Test procedure
The exercise stress test is performed in a suitably equipped examination room in many cities across Poland 
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Electrodes connected to an ECG recorder are attached to the skin of the chest after any oils have been removed, and a cuff is placed around the arm to monitor blood pressure during the test. An ECG is performed before the test. The exercise stress test begins with slow walking on the treadmill. At intervals, the incline and speed of the treadmill are increased. An exercise stress test on a cycle ergometer involves gradually increasing the resistance while maintaining a constant pedalling speed, giving the patient the sensation of cycling at a steady speed up an increasingly steep hill. Throughout this time, the ECG is recorded continuously and blood pressure is recorded periodically, while the doctor supervising the test monitors and assesses any changes. The patient is asked to report any concerning symptoms (chest pain, shortness of breath, dizziness, severe fatigue). The exercise stress test continues until the point determined by the cardiologist, based on the patient reaching a given heart rate or developing the symptoms mentioned above.
Purpose of the test
The exercise stress test is the most commonly performed electrocardiographic test for detecting signs of ischaemic heart disease. The test also assesses physical fitness. It allows a detailed assessment of how the heart functions in response to increased physical exertion. This type of cardiac diagnostic testing enables heart disease to be detected and treatment to be started at an early stage, preventing the development of symptoms that would be noticeable at rest. In addition, the exercise stress test helps establish a rehabilitation plan for people who have had a heart attack or have heart disease, and checks the effectiveness of prescribed medicines.
Indications for the test
- Participation in sport, to detect hidden heart defects
- Changes visible on a resting ECG.
- Heart rhythm disturbances.
- Assessment for the appropriate stage of rehabilitation in people who have had a myocardial infarction or a heart transplant.
- Suspected ischaemic heart disease.
Preparing for the test
You are advised to refrain from smoking, eating and drinking for approximately 4 hours before the test. You are also advised to wear comfortable shoes and clothing. Your usual medicines should be taken or stopped as advised by your cardiologist. You should undergo an initial cardiac assessment by the doctor performing the exercise stress test. If there are no contraindications to the test, it can be repeated as needed.
Contraindications to the test
- Chest pain
- Recent myocardial infarction.
- Unstable angina.
- Unstable coronary artery disease.
- Dangerous heart rhythm disturbances.
- High blood pressure exceeding 180/110 mm Hg.
- Acute infectious diseases.
- Musculoskeletal and nervous system disorders that prevent the test from being performed.
When will the results be available?
The patient receives the results on the day of the exercise stress test. After the test, the cardiologist analyses the results and prepares a report. The results are provided as a written report with the ECG recordings attached.
Where and how can you have the test?
The exercise stress test is performed at many cardiology clinics across Poland.
