Exercise Stress Test (EST)

Exercise stress tests have been used since the 1930s to aid in the diagnosis, treatment, and prediction of heart disease. Chesapeake Cardiac Care offers in-office exercise stress tests where our highly trained technicians use a number of different protocols to accommodate your specific medical needs. In addition, they are trained to perform needed interventions if any complications arise during the test.

What is an exercise stress test?

An exercise stress test (EST) is a diagnostic cardiac stress test that cardiologists use to assess how well your heart functions at rest and under stress, which occurs during physical exertion or while exercising. By evaluating your heart in both situations, we can assess whether there are blockages in your heart and what your risk for having a heart attack is. For a full list of what the EST does, please view our cardiac stress test page.

How is an EST performed?

You will come to our office, where a physician and a technician will conduct the test. You will have sticky patches (called electrodes) put on your chest to monitor your heart during the test. The electrodes are attached to an electrocardiogram (ECG) monitor, which tracks the electrical activity in your heart throughout the entire test. We may also use radionuclide imaging or sonographic imaging to supplement the EST in order to gain more accurate readings. During the test, we will consistently measure your blood pressure to look for indicators of concern.

Before you start, we will measure your heart rate and blood pressure, which will be our baseline, or resting measurements. You will be asked to walk on a treadmill, slowly at first and then the difficulty level will slowly increase. Every couple of minutes, we will increase the speed at which you are moving, as well as the incline.

During our stress tests, we use standardized protocols, or guidelines, to determine the exercise times and level of difficulty. These allow us to vary the difficulty of the test to meet your specific needs. An active patient, for example, would get the standard protocol, which is called the Bruce protocol. The Bruce protocol outlines certain stages for the test, and each stage has a set speed for your pace, percentage at which the incline should be increased, and amount of time it will last. For our patients who are comfortable with a lower level of exercise, we will use the Naughton protocol, which is not as rigorous.

The gradual increase in the difficulty of exercise will continue until one of the following occurs:

  • Target heart rate is reached
  • Pain and discomfort occurs, such as chest pains, tiredness, or other physical ailments
  • Blood pressure levels become of concern
  • Heart muscle is not receiving enough oxygen, according to ECH

Once the test is over, you will be monitored until your heart rate returns to its normal baseline.

How long does the EST normally last?

Exercise stress tests normally take about an hour.

What do I have to do to prepare for the EST?

Please see our Cardiac Stress Test Preparation page.