STRESS TESTING

Other Names: exercise tolerance test (ETT), exercise stress test, exercise treadmill test, Exercise ECG/EKG; Stress ECG; Exercise electrocardiography.

Description/Test Basics/Reasons for the test: An exercise stress test provides an overall look at the health of your heart.  It is used to measure the effect of exercise on your heart by recording the heart's electrical activity during exercise as well as determine the causes of chest pain, identify rhythm disturbances during exercise and help diagnose heart disease.  Stress testing is a painless, safe and non-invasive method to measure how well the heart responds to an increase in the body's demand for oxygen.  An electrocardiogram measures the patient's heart rhythm before, during and after exercise. The subtle changes in ecg readings can help Dr. Qureshi to, among other things:

  • Locate areas of the heart that receive an insufficient blood and oxygen supply;
  • Reveal heart rhythm abnormalities;
  • Verify the effectiveness of medical and surgical therapies; and
  • Determine physical fitness.


An Exercise Tolerance Test or Stress Test records the heart's electrical activity (rate and rhythm) during exercise. It is useful chiefly in the diagnosis of coronary artery disease. By placing the stress of exercise on the heart, the test can bring out abnormalities caused by partial blockages in the coronary arteries – abnormalities that are often completely unapparent at rest.An electrocardiogram (ECG) stress test monitors a person's heartbeat at rest and during exercise, most commonly while a person walks on a treadmill. A physician observes the person, monitors the exercise level, and makes recordings until the person's heart nears a maximum predicted heart rate. The heart also is monitored during the period of cool-down or recovery that immediately follows exercise. The recordings made before, during, and immediately after an ECG stress test can show subtle changes in heart electrical activity that can help a physician:

  • Determine physical fitness;
  • Locate areas of the heart that receive an insufficient blood and oxygen supply;
  • Reveal heart rhythm abnormalities;
  • Evaluate a person's prognosis after a heart attack;
  • Verify the effectiveness of medical and surgical therapies; and
  • Determine an appropriate exercise program for people with known heart disease.


Test preparation/pre-test guidelines:

  • You must not eat, smoke, or drink beverages containing caffeine or alcohol for a minimum of 24 hours prior to the test.
  • You should not take any of your medications the day of the test.
  • Wear comfortable shoes and loose clothing to allow exercise.
  • You may not eat or drink anything 5-6 hours prior to the test.  Should you chose to eat 5-6 hours prior to your stress test, it must be light- for example, a small amount of oatmeal, a slice of toast, a little juice.

The physician often provides written instructions before the test, which the patient should follow closely. Typically it is recommended that people wear clothing that is comfortable to exercise in and avoid strenuous exercise and eating or drinking for approximately 4 hours before the test. The testing center may also request that the person refrain from using tobacco, certain prescription and nonprescription drugs, and alcohol or caffeine for 24 hours before the test. 

Test process/How the test is done: Prior to the test, ten electrodes will be placed on your chest just as they would be for an electrocardiogram (ECG). Your blood pressure, heart rate, and ECG will be recorded at rest, usually while you are lying on your back and again when standing.  You will then be asked to perform a "graded" exercise test on a motor-driven treadmill.  The physicians or technologist may stop the test at any time for medical reasons. You may ask to stop the test at any time because of significant fatigue or discomfort.  However, we encourage you to exercise as long as possible so that we may assess your heart under maximum stress.

Prior to your stress test, approximately 10 electrodes will be attached to the patient's chest, just as they would be for an electrocardiogram (ecg). The preparation of the electrode sites on your chest may produce a mild burning or stinging sensation.  The electrodes may be placed on top of a light layer of gel that conducts electricity and helps ensure clear readings. Men should expect to have some chest hair shaved so that the electrodes will press directly against the skin. This ensures the best possible signal quality.  The electrodes record the heart's electrical impulses or rhythm prior to the stress test, during the stress test and after the stress test.  Patient's will also wear a blood pressure monitoring cuff or monitoring device during the test that will take their blood pressure at predefined intervals during the stress test.  The stress technician will then review with the patient correct technique for conducting the stress test- ie, posture, position on the treadmill, eyes open, bringing to the technician's attention any symptoms the patient may experience.

As exercise begins, the patient walks slowly on the treadmill. The exercise-protocol that you will follow will be determined by the cardiologist supervising your test, but will begin at a relatively easy level and become progressively more difficult with each subsequent stage, typically about every 3 minutes. Your heart rate, blood pressure and ECG will be measured and recorded at frequent intervals during the stress test.   The blood pressure cuff on your arm will be inflated every few minutes, producing a squeezing sensation that may feel tight.  The test typically ends once the person reaches the target heart rate (usually 220 beats per minute minus the person's age), or if he or she cannot continue because of symptoms such as fatigue, dizziness, palpitations, shortness of breath, or chest pain. The physician or technologist may stop the test at any time for medical reasons. You may ask to stop the test at any time because of significant fatigue or discomfort.  However, we encourage you to exercise as long as possible so that we may assess your heart under maximum stress.  The physician then evaluates the test results and discusses them with the patient at their follow-up visit.

Adenosine, or medication-induced stress testing is available for people who cannot exercise. Some of the side effects of adenosine reported by our patients are:

  • Headach
  • Dizziness
  • Chest Pressure
  • Difficulty breathing
  • Tingling hands and feet
  • Nausea; and
  • Flushing 

Post-test guidelines: Most patients resume usual activities immediately following ECG stress testing.  Patient's will be asked to refrain from taking a shower for a minimum of 6 hours after the stress test. 

Test location:  Your stress test will be performed at our main office, located in Denton, Texas:    

The Heart Center of North Texas
3304 Colorado Blvd.
Suite 101
Denton, TX 76210




HOSPITAL PRIVILEGES:   •  Denton Regional Medical Center   •  Texas Health Presbyterian Hospital Denton
   •  Muenster Memorial Hospital   •  North Texas Medical Center


© 2011. Heart Center of North Texas. All rights reserved.


Referring Physicians    |    Locations    |    Contact
Dallas Web Design by Interaria





(940) 566-2358