Stress Exercise

Exercise Stress Testing
In an exercise stress test, the patient walks on a treadmill (most common) or pedals a stationary bicycle or arm crank. Exercise intensity progresses according to established protocols. The Bruce protocol, for example, is a common treadmill protocol in which the speed and grade of the treadmill are increased every 3 minutes.The goal of the test is to increase the heart rate to the “target heart rate.” This is 80% to 90% of the maximum predicted heart rate and is based on the age and gender of the patient. During the test,the following are monitored: two or more ECG leads for heart rate, rhythm, and ischemic changes; BP; skin temperature; physical appearance; perceived exertion; and symptoms including chest pain, dyspnea, dizziness, leg cramping, and fatigue. The test is terminated when the target heart rate is achieved or when the patient experiences chest pain, extreme fatigue, a decrease in BP or pulse rate, serious dysrhythmias or ST segment changes on ECG, or other complications. When significant ECG abnormalities occur during the stress test (ST segment depressions), the test result is reported as positive and further diagnostic testing is required.