Cardiac Stress Test/ Exercise Stress Test (EST)

What is a Stress Test?

An Exercise Stress Test (EST) is an ECG performed under conditions of gradually increasing physical exercise. This exercise is performed on a treadmill which increases in speed and incline to assess ECG changes which may reveal changes suggestive of coronary heart disease.

How is the Test Performed?

You will have ECG leads attached to you as well as a blood pressure cuff during the test. A resting blood pressure and ECG will be taken. Your Cardiologist will be with you throughout the test monitoring your ECG and physical symptoms until your maximum effort/workload is achieved, ECG changes occur, decrease in blood pressure or physical symptoms require the test to be stopped.

Your test will be conducted and interpreted using the Bruce protocol. The treadmill is started on a slow speed and the inclination and speed will increase every 3 minutes. The protocol dictates the precise speed and slope which alters every 3 minutes and is also referred to as Stage 1, 2 and 3. Blood pressure is recorded during each stage.

Your ECG recording continuously on the monitor, however every one minute interval will be recorded on paper. The treadmill is stopped when the patient achieves a target heart rate. This is 85% of maximal heart rate predicted for patient's age.

The test may also be stopped if chest discomfort, jaw or arm pain occurs or if there is shortness of breath, dizziness, a drop in blood pressure, unsteady gait or ECG changes.

Preparation for a stress test

  • Do not eat or drink large amounts for a couple of hours prior to the test.
  • If you are diabetic and using Insulin please check with your Cardiologist if special instructions are required.
  • Check if certain medications need to be stopped one or two days prior to the test.
  • Wear loose, comfortable clothing and shoes suitable for exercise.
  • Please inform your doctor if you have had any chest or jaw pain or arm discomfort.


There is a small risk of cardiac arrhythmia that may result in further complications such as irregular heart beats, unrelieved chest pain or heart attack. While this may sound alarming, it is rare and would be no different if the patient should experience difficulties while performing any form of strenuous exercise. Experienced medical staff and medical equipment is on hand.