Exercise Stress Test

What is Exercise Stress Test?

Exercise stress test allows us to assess the response of your heart to the increased workload and demand for blood during exercise. This is done by recording the electrocardiograph (ECG) of your heart while walking on a treadmill machine. It is useful in diagnosing ischaemic heart disease (reduced blood supply to the heart muscles due to coronary artery disease).

Is the test safe?

The test is generally very safe. There is a very low risk of complications in stress testing.

Possible adverse side effects for treadmill stress test include:

• Life-threatening heart rhythm (<0.2%)
• Acute myocardial infarction (0.1%)
• Death (0.1%)
• Fall

If you are not keen for this procedure, you will need to discuss with your doctor in your next clinic visit. If you are unable to exercise on a treadmill machine, you may then be requested to undergo another test that may involve use of medication (Pharmacological Stress Echocardiogram), radionuclide myocardial perfusion scan, magnetic resonance stress imaging.

Can I undergo the test if I am not feeling well?

If you are feeling unwell because of fever, running nose or acute illness, you should not proceed with the procedure. Please call the NHCS Call Centre at +65 6704 2000 to reschedule the test.

Preparations before the test

• Check with your doctor if you are required to stop your medication for hypertension (high blood pressure) 3 days before the test.
• Take a light meal before your test.
• Do not apply lotion, oil or powder to the chest.
• Bring your running shoes, socks, exercise attire and towel. Socks are also available at $2+ a pair (including GST). It is necessary to wear socks if you are using the running shoes provided by NHCS.
• For males, please shave your chest before coming so that the ECG electrodes can be placed on your chest.
• Informed consent prior to the test is required. For patients below 21 years old, please be accompanied by a parent for consent taking.

How is the test done?

The Cardiac Physiologist/Technologist will place ECG electrodes on your chest and a blood pressure cuff around your arm for continuous monitoring throughout the test. Thereafter, the doctor will assess your condition and you will be asked to sign on the consent form before starting your treadmill test.

Your blood pressure will be taken and an electrocardiogram (ECG) of your heart at rest will then be recorded. The Cardiac Physiologist/Technologist will then demonstrate on how to walk on the treadmill. The treadmill will start off at a slow speed. Thereafter, the speed and gradient of the treadmill will increase gradually at a regular interval of 3 minutes. Your blood pressure, heart rate, ECG and general condition will be monitored closely during the test. As the stages of the test progress, it can get quite strenuous. Please inform the doctor or Cardiac Physiologist/Technologist to stop the treadmill at any time should you feel tired, unwell or unable to continue. Please note that once you discontinue the test, you will not be able to redo or continue with the test.

When the exercise test ends, you will be asked to rest on the bed for approximately five minutes while your ECG and blood pressure are being monitored and recorded.

The ECG, heart rate, blood pressure response and symptoms recorded during the test will be analysed and the report will be given to your doctor.

The entire procedure will take around 1 hour and this does not include the waiting time.

What can I expect after the procedure?

You will be monitored for some time after the procedure if you do not feel well. If the symptoms persist, you may be admitted for observation. If the test turns out to be abnormal, you may also be admitted for further management after discussion with your doctor.

Video - Treadmill Exercise ECG Test