The "treadmill test" obtains an electrocardiographic record from the patient at rest, during, and after graded exercise with the patient walking on a moving belt (treadmill). The test not only measures exercise tolerance objectively, but also is designed to elicit symptoms and/or electrocardiographic changes that are brought on by exercise. The test is valuable in the diagnosis and risk-stratification (assessment of the severity) of patients with known or suspected coronary artery disease (CAD) and in selected asymptomatic patients who are being screened for possible CAD. The test is also valuable in assessing the patient after recovery from a heart attack, and in patients with known CAD on medical therapy, or after balloon angioplasty or coronary bypass surgery treatment.
Preparation for the Test
Do not eat or drink anything except water for three hours before taking the test. Your physician will instruct you about whether to take your routine medications. Either bring or wear clothing and shoes that will be comfortable for walking.
The Procedure
A nurse or exercise technologist will place electrodes on your chest. For the clearest test results the skin may need to be lightly scraped. Men may need to have some of their chest hair shaved. A blood pressure cuff will also be placed on your arm. After a resting electrocardiogram is recorded, you will walk on the treadmill. The speed and elevation of the treadmill will be increased at three minute intervals. While you are walking, the physician and technologist will monitor your heart rate, electrocardiogram, and blood pressure (BP). The test will be stopped when you have reached a predetermined heart rate, or at your request if you cannot walk any further, or feel chest pain or shortness of breath. Upon termination of exercise, you will rest on the examining table and your electrocardiogram and BP will be monitored for an additional 5 to 10 minute period.
Risk of the Procedure
The risk of treadmill exercise testing is very small and is equivalent to the risk of a similar degree of exercise experienced in the patient's daily life. The careful monitoring of the patient, his/her blood pressure, and the continuous electrocardiographic record, all serve to further minimize the small risk of the test.