Stress test
An electrocardiogram taken while the heart is working. This is the test for pain that only appears with exertion.
What it measures
- What it measures
- Records the electrocardiogram, blood pressure, and symptoms while you walk on a treadmill at increasing effort. It looks for ischemia invisible at rest, arrhythmias triggered by exertion, and how much activity the heart tolerates before showing strain.
- Duration
- Between 30 minutes and 1 hour
- Preparation
- No fasting. Bring any previous test results and the list of medicines you take. Also comfortable clothes and running shoes.
- What it feels like
- It is real exercise and it is tiring: you walk until reaching a target heart rate or until a symptom appears. You are monitored throughout and it stops as soon as needed.
- Referral from another doctor
- No
- Results
- Same day
- Where it is done
- In the office
What it shows
The diagram shows the SHAPE of the test, not a protocol. How many stages are completed depends on the protocol and on each person: the five steps are a staircase, not a count. It declares no measurement — there are no speeds, gradients or times.
- 01
- Rest. The starting trace, with the heart calm: it is all a resting electrocardiogram in the office gets to see.
- 02
- Stages. They all last the same and each one asks for more than the last: the treadmill runs faster and steeper.
- 03
- Recovery. The test does not end when you stop walking; this part is recorded just like the effort.
- 04
- Recording. The electrocardiogram runs from start to finish, and blood pressure is taken through the test.
There is a kind of pain a resting electrocardiogram cannot explain: the kind that appears climbing stairs or walking fast and eases when you stop. With the heart at rest, partially narrowed arteries still meet demand and the tracing looks normal. The stress test creates the demand so it can be seen.
Beyond the electrical finding, the test gives a number a patient can use: how much effort is safe. That guides everything from an exercise routine to a surgical decision.
Not every patient is a candidate. A joint problem, an active arrhythmia, or uncontrolled blood pressure can rule it out, and alternatives exist for those cases.