Exercise Stress ECG

Aberdeen

An exercise stress ECG, also known as an exercise tolerance test or ETT, records the electrical activity of your heart while you walk on a treadmill. It shows how your heart responds as exercise becomes gradually harder.

What is an exercise stress ECG?

Small sticky electrodes are attached to your chest and torso and connected to an ECG machine. Your
blood pressure and symptoms are monitored before, during and after exercise.
The treadmill starts slowly, then becomes faster and steeper every three minutes — usually following
the Bruce protocol — so your heart’s response to increasing effort can be assessed.

The test is supervised by trained staff, with emergency equipment available.

How this differs from an ECG or an echocardiogram

Three tests are often confused. In short:
  • Resting ECG: records your heart’s electrical activity while you are still.
  • Exercise stress ECG: records that same electrical activity while you exercise.
  • Echocardiogram: uses ultrasound to produce moving images of the heart’s structure, pumping function and valves.
They answer different questions, and your clinician may recommend more than one.

Why the test may be requested

  • To assess exercise capacity, symptoms, heart rhythm or blood pressure response during exercise.
  • To support risk assessment in selected patients with known coronary artery disease.
  • To assess palpitations or rhythm changes that occur on exertion.
  • To assess response to treatment, medication, rehabilitation or a previous cardiac procedure.
  • To provide information required for selected occupational, fitness, driving, aviation, diving or sport-related medical assessments.
  • To help clinicians decide whether further cardiology review or additional tests are needed.
 
Is a stress ECG the right test?
An exercise stress ECG is not the routine first-line test for diagnosing suspected stable angina or suspected coronary artery disease, where CT coronary angiography or functional imaging may be more appropriate. Your referring clinician decides whether this test suits the reason it has been requested.

When not to attend, and when to seek urgent help

Do not attend for a routine exercise stress ECG if you have had any of the following:

 

  • New, worsening or unstable chest pain, or chest pain at rest
  • Severe breathlessness
  • Fainting or collapse
  • New severe palpitations
  • Symptoms that could suggest a heart attack
  • Acute illness or fever
  • Any other symptom that feels urgent, or significantly different from usual
 
In an emergency, call 999 or go to your nearest emergency department.

Preparing for your appointment

  • Wear comfortable clothing suitable for walking briskly on a treadmill.
  • Wear trainers or flat shoes with good grip. Open-toed shoes, sandals and heels are not suitable.
  • Avoid body lotion, oils or heavy creams on your chest on the day — electrodes may not stick.
  • Eat a light meal beforehand unless you have been advised otherwise. Avoid a heavy meal immediately before the test.
  • Follow the medication instructions given by your referring clinician. Do not stop prescribed medication unless you have been specifically told to.
  • Bring a list of your current medication, including inhalers, sprays and over-the-counter medicines.
  • Allow enough time for preparation, exercise, recovery and post-test checks.

What happens during the appointment

1. We go through the test with you, check your symptoms and medication, and answer your questions before asking for your consent.
2. Electrodes are attached to your chest and torso. You will need to remove clothing from the upper body so they can be placed accurately, and a chaperone is always available if you would like one. Small areas of skin are cleaned first, and hair may need clipping so the electrodes stick.
3. We record a resting ECG, heart rate and blood pressure before you start.
4. The treadmill starts slowly, then gets faster and steeper every three minutes. Your ECG, blood pressure and symptoms are watched throughout.
5. Afterwards you rest while we keep monitoring you for several minutes, until it is safe for you to leave.

During the test

Tell the physiologist straight away about chest discomfort, breathlessness, dizziness, palpitations, leg pain, unusual fatigue, feeling faint, or anything that feels concerning. You can ask to stop at any point, and the physiologist will also stop the test if there is a clinical reason to.

Possible risks and side effects

Most people complete the test without any serious problem. Tiredness, breathlessness, leg fatigue, mild chest discomfort, palpitations or light-headedness can happen during exercise, and settle afterwards.

Less commonly, exercise can bring on significant changes in heart rhythm or blood pressure, worsening chest pain, fainting or a cardiac event. The test is supervised by trained staff with emergency equipment available, and is stopped if any safety concern arises.

Your results

Your test is sent for specialist reporting. The report is available within 24 hours, and often on the same day.

It goes to your referring clinician, who will explain the result and agree any next steps with you. If anything urgent or unexpected shows up during the test itself, it is acted on immediately rather than waiting for the report.

How to book and referral information

A referral is required for a stress ECG. You can get one by seeing a ROC doctor, or be referred by your own GP or specialist. You are welcome to book in advance, but your referral must reach us by the day before your test.

Do get in touch before your appointment if you are pregnant, have a pacemaker or other implanted cardiac device, have mobility or accessibility needs, have been in hospital recently, or if your symptoms have changed since you were referred.

Payment and insurance

We offer straightforward self-pay options. ROC is also BUPA approved. If you are using health insurance, you must obtain pre-authorisation from your insurer before your appointment.

Why have your stress ECG at ROC?

  • Rapid access
  • Experienced cardiac physiologists
  • Reported within 24 hours
  • Supervised throughout, with emergency equipment on site
  • No hassle booking process
  • Billing to insurers, subject to pre-authorisation

Get in touch

To arrange a stress ECG or ask about a referral, contact our Aberdeen clinic.

Get in touch