Exercise Stress Test

What is an exercise stress test (EST)? A test to check the health of the heart when the patient is exercising. Exercise makes the heart pump harder, some conditions that can't be detected by an electrocardiogram while at rest can be found by an exercise stress test, which includes an electrocardiogram while the heart is pumping faster. The exercise stress test is also called a treadmill test, though sometimes a stationary bicycle is used instead of a treadmill.

Your doctor may recommend an exercise stress test to check for or help diagnose certain conditions. These conditions include coronary artery disease (CAD) and heart rhythm problems (arrhythmias). An exercise stress test can also be used to guide treatment of certain heart disorders.

Preparing for the test

How should you prepare for an exercise stress test? Depending on where you go for your EST, you may be asked not to eat, drink, or smoke before your stress test. There may also be a limitation on caffeine, you may be asked to avoid caffeine for 24 hours before the test. If you use an inhaler, be sure to bring it with you to the test and let your doctor or technician know about it. Make sure that your doctor knows about all medications that you're taking, including Viagra, Cialis, and Levitra. You may be asked to hold medication for 24 hours before the test, make sure to let your doctor know if discontinuing medication causes chest pain or any other symptoms. Wear comfortable shoes and clothing for the test.

During the test

An EST can take about an hour. Patients that undergo an exercise stress test have electrodes attached to their chest and have their blood pressure taken. The electrodes are attached to the patient's chest as part of an ECG that is part of the exercise stress test to detect arrhythmias, palpitations, and certain indicators of cardiac health. For an EST, you'll likely walk on a treadmill or pedal on a stationary bike. As the test progresses, the exercise will get more difficult. The test ends when the patient reaches a target heart rate, the test also ends if the patient develops symptoms like fatigue, dizziness, chest pain, shortness of breath, or if the patient is too uncomfortable to continue.

Your Results

Normal results for an EST mean that you exercised for at least an adequate amount of time and you didn't have any concerning symptoms, changes in blood pressure, or a concerning ECG.

Abnormal results for an EST could mean that you had an abnormal heart rhythm or certain indications in your ECG that you may have blockage in the arteries. The results of your test may lead your doctor to recommend further testing to check for certain conditions, or a false positive.


An exercise stress test is generally safe, though there is a risk of complications, such as low blood pressure, abnormal heart rhythms, and heart attack. A heart attack is rare, but possible as a result of an exercise stress test. Both low blood pressure and abnormal heart rhythms brought on by exercise usually go away after you stop exercising.