Stress ECG

A resting ECG if often normal in patients with coronary artery disease as at rest the heart muscle does not have to work very hard and the blood supply can cope. However, when the heart is exercised and the heart muscle required more blood and oxygen the ECG can change to show that the heart muscle is not getting enough oxygen ('ischaemia'). An exercise test is a carefully monitored stress test where the heart is exercised and the ECG and blood pressure carefully monitored to look for symptoms, blood pressure changes and any changes on the ECG to suggest ischaemia.


The test is most commonly performed on a treadmill according to asset and international protocol (usually the 'Bruce' protocol). The treadmill starts slowly but every three minutes becomes slightly steeper and faster to increase the heart rate. The aim is to get the heart rate up to a 'target' heart rate at least (taken as 75% of maximum predicted heart rate based on age).
Obviously the test is not suitable for those who have difficulty walking and a stress echo or myocardial perfusion scan are often used in stead in these cases.
An abnormal exercise ECG is often followed up by a coronary angiogram which can then identify any narrowings in the arteries of the heart that might be causing symptoms.


The risk of cardiac stress testing is very small, and is only carried out by skilled personal and where emergency cardiac drugs and resuscitative equipment are immediately on hand for the very rare cases they are needed.

Please note:

Every effort has been made to ensure that the information on this website is up-to-date and accurate. However, it is intended to serve as a guide only. Symptoms may vary and if you have any medical concerns you should always consult a healthcare professional.