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The
heart is a muscular pump in the body powered by its
own electrical system. Each time the heart beats, muscle tissue in the heart
contracts and then relaxes, pumping blood to itself and to the rest of the
body. Electrocardiography (EKG, ECG) is a test done to record the electrical
activity of the heart. Exercise electrocardiography (sometimes called a stress
or treadmill test) is electrocardiography done during exercise to evaluate how
the heart responds to the demands of physical activity.
The electrical signals produced by the heart can be detected
through the skin by small metal discs called electrodes. During
electrocardiography, the electrodes are attached to the skin on your chest,
arms, and legs. The electrodes are also connected to a machine that translates
the electrical activity into line tracings on paper. These tracings are often
analyzed by the machine and then carefully reviewed by a doctor for
abnormalities.
During exercise, your heart needs more oxygen. When your heart is
relaxed, it may get enough blood through the openings in your
coronary
arteries, even if your arteries are clogged or narrowed. However, when
your heart is under stress, it requires more blood and oxygen. During stress,
any blockage or narrowing in your arteries may become more apparent, because
your heart needs more blood during exercise and your narrowed arteries may not
be able to supply it.
If a large part of your heart is affected by poor blood flow, an
electrocardiogram may show abnormalities, especially during exercise. Since
these abnormalities often don't appear on an EKG taken during rest, an exercise
EKG is often more sensitive in detecting
coronary artery disease (CAD). See an illustration of
coronary
artery disease.
During exercise electrocardiography, you may either walk on a
motor-driven treadmill or pedal a stationary bicycle.
Exercise Electrocardiography Results
Your doctor may be able to discuss the preliminary results with you
immediately after the test. However, complete test results may take several
days.
You reach your "target" heart rate (based on your age) and
can exercise without chest pain, other symptoms of
coronary artery disease, or abnormalities in your
blood pressure or EKG.
Your blood pressure increases steadily during
exercise.
Your EKG tracings do not show any significant
changes.
Abnormal:
Chest pain develops during or immediately after the
exercise.
Other symptoms of heart disease develop, such as dizziness,
fainting, or extreme shortness of breath.
Your blood pressure drops or does not rise during
exercise.
The
EKG
tracing shows abnormal ST segments. ST segments drop and stay low for
more than 3 minutes during exercise or immediately after the test. This may
mean impaired blood flow to the heart muscle. Certain changes in the ST
segments of the EKG may suggest the presence of a previous heart attack or poor
blood flow to the heart.
During peak exercise, an extra heart sound (third heart
sound) or a
heart murmur develops.
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