How Is an Exercise Stress Test Performed?

Medically Reviewed on 12/30/2022
Exercise Stress Test
An exercise stress test is performed to learn your heart’s functioning during physical activity.

An exercise stress test, also known as a treadmill test, exercise test, or stress test, helps your doctor determine how well your heart functions during physical activity. Since exercise makes your heart function and pump harder, the stress test may reveal problems with blood flow within your heart.

An exercise stress test is a commonly performed test that involves walking on a treadmill or riding a stationary bike while simultaneously monitoring the heart rhythm, blood pressure, and breathing.

A stress test usually takes about an hour, including preparation time and the time taken to perform the test (15 minutes).

Stress test procedure

Steps involved in an exercise stress test include:

Before the test (preparation)

  • You may be asked to avoid eating, drinking (including caffeine), or smoking for some time before a stress test. 
  • You may be asked to continue taking all your prescription and over-the-counter medications before the test if not recommended otherwise.
  • If you use an inhaler, ensure that your doctor and the healthcare team member monitoring your stress test are aware of it.
  • if you use an inhaler for asthma or other breathing problems, ensure to bring it to the test.
  • Wear lightweight and comfortable clothes and shoes.
  • Inform about your current medical history and the intensity of exercise you are used to.

During the test (actual test)

  • A nurse or technician places electrodes (sticky patches) on the chest, legs, and arms, which are connected to the EKG machine.
  • Body hair may be shaved (if needed) to help the electrodes stick. 
  • A few wires connect the sensors to a computer that records the electrical activity of the heart.
  • A cuff is tied to the arm to check your blood pressure during the test. 
  • You may be asked to breathe into a tube to determine your breathing capabilities.
  • You are asked to initiate exercise on a treadmill or stationary bike, gradually increasing the intensity.
  • The exercising is continued until the heart rate has reached a target level or until you have signs and symptoms that prohibit you from continuing. These signs and symptoms may include:
  • The doctor will continuously watch your heart activity and stop the test if there are any concerns.

After the test

  • After exercising, you may be asked to stand still for several seconds and then lie down with the monitors in place until the heart rate and breathing return to normal.
  • You may return to normal daily routine activities unless advised otherwise.


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What are the indications for an exercise stress test?

An exercise stress test is performed to determine the heart’s functioning during physical activity. A stress test can help with the following:

  • Guide treatment decisions.
  • Determine the performance of current heart treatment (if any).
  • Diagnose the severity (improving or deteriorating) of an existing heart condition.

People with high-risk occupations (pilots or professional athletes) may need stress tests regularly.

The doctor may recommend a stress test to diagnose or determine the following:

Are there any risks involved in exercise stress tests?

Although an exercise stress test is considered safe, very rarely, some risks or complications may develop:

Contraindications of stress tests include:

Medically Reviewed on 12/30/2022
Image Source: iStock image

Stress test Mayo Clinic:

Exercise Stress Test Cleveland Clinic:

Exercise Stress Test American Heart Association:

What is a Stress Test? Penn Medicine: