Exercise treadmill test
This test is used by cardiologists to assess patient with a wide range of cardiac symptoms such as chest pain, shortness of breath or exercise induced arrhythmias. The test works by recording the 12 lead electro-cardiogram at rest and then following graded periods of increasing exercise.
The most common method of exercise testing uses the Bruce protocol named after Dr Robert A Bruce. Before the development of the Bruce Protocol there was no standardized method that could be used to monitor cardiac function in exercising patients. In 1963 Bruce and his colleagues developed a treadmill based exercise test. The test involves walking on a treadmill while the heart is monitored, in addition it is also possible to measure ventilation volumes and respiratory gas exchange, before, during and after exercise. During the test an ECG is taken every minute and blood pressure at the end of every 3 minute stage. Because the treadmill speed and inclination can be adjusted most patients who are able to walk can do an exercise test. Apart from being able to detect angina exercise testing is useful in screening apparently healthy people for early signs of coronary artery disease.
Safety of Exercise Tests:
This test is performed very frequently and is safe provided a patient is properly assessed before the test. Patients with unstable coronary artery disease or critical valvular heart disease should not be exercised. Some patterns of resting ECG such as left bundle branch block make interpretation of the test very difficult. The risk of death associated with an exercise test is 1 in 10,000.
What to bring to an Exercise Test:
No special preparation is needed however you are advised not to have a heavy meal before an exercise test. You will be walking quickly and possibly running so a comfortable pair of trainers is the most appropriate type of footwear. We provide a gown for female patients to wear and a towel to remove any perspiration. We will also be able to provide a glass of water at the end of the test.
Interpretation of Exercise Tests:
Interpreting an exercise test requires skill and experience and should only be performed by an appropriately trained doctor, usually a cardiologist. Various abnormalities are associated with coronary artery disease but the most common one is called ST depression but other changes can occur. When an exercise test is used to assess patients with possible angina the result of the test is usually described as either positive (showing ECG changes consistent with coronary artery disease) or negative (not showing any ECG changes consistent with coronary artery disease).
Before the exerise test is performed the cardiologist has made a clinical assessment of how likely the patient is to have coronary artery disease. This is based on symptoms, any previous cardiac history and the presence of cardiac risk factors. A positive exercise test does always mean a person has coronary heart disease. Exercise testing is most useful when there is an intermediate risk of coronary artery disease. If the risk is low to begin with then even after a positive exercise test the risk is still low, similarly if the risk is high to start with then a negative exercise test does not rule out coronary artery disease.
The most common method of exercise testing uses the Bruce protocol named after Dr Robert A Bruce. Before the development of the Bruce Protocol there was no standardized method that could be used to monitor cardiac function in exercising patients. In 1963 Bruce and his colleagues developed a treadmill based exercise test. The test involves walking on a treadmill while the heart is monitored, in addition it is also possible to measure ventilation volumes and respiratory gas exchange, before, during and after exercise. During the test an ECG is taken every minute and blood pressure at the end of every 3 minute stage. Because the treadmill speed and inclination can be adjusted most patients who are able to walk can do an exercise test. Apart from being able to detect angina exercise testing is useful in screening apparently healthy people for early signs of coronary artery disease.
Safety of Exercise Tests:
This test is performed very frequently and is safe provided a patient is properly assessed before the test. Patients with unstable coronary artery disease or critical valvular heart disease should not be exercised. Some patterns of resting ECG such as left bundle branch block make interpretation of the test very difficult. The risk of death associated with an exercise test is 1 in 10,000.
What to bring to an Exercise Test:
No special preparation is needed however you are advised not to have a heavy meal before an exercise test. You will be walking quickly and possibly running so a comfortable pair of trainers is the most appropriate type of footwear. We provide a gown for female patients to wear and a towel to remove any perspiration. We will also be able to provide a glass of water at the end of the test.
Interpretation of Exercise Tests:
Interpreting an exercise test requires skill and experience and should only be performed by an appropriately trained doctor, usually a cardiologist. Various abnormalities are associated with coronary artery disease but the most common one is called ST depression but other changes can occur. When an exercise test is used to assess patients with possible angina the result of the test is usually described as either positive (showing ECG changes consistent with coronary artery disease) or negative (not showing any ECG changes consistent with coronary artery disease).
Before the exerise test is performed the cardiologist has made a clinical assessment of how likely the patient is to have coronary artery disease. This is based on symptoms, any previous cardiac history and the presence of cardiac risk factors. A positive exercise test does always mean a person has coronary heart disease. Exercise testing is most useful when there is an intermediate risk of coronary artery disease. If the risk is low to begin with then even after a positive exercise test the risk is still low, similarly if the risk is high to start with then a negative exercise test does not rule out coronary artery disease.
