Exercise ECG

An exercise ECG, also called an exercise tolerance test, is an electrocardiogram (ECG) that is recorded while you are walking on a treadmill or cycling on an exercise bike. The aim of the test is to see how your heart works when you are exerting yourself.

What can an exercise ECG show?

The exercise ECG helps doctors find out if you have coronary heart disease, as it shows whether your heart muscle is getting enough blood from the coronary arteries during physical activity. It can also show if you have been having symptoms of angina as any areas where there is a lack of oxygen to the heart is reflected on the ECG tracing. 

Some people are asked to have an ECG after procedures, such as coronary angioplasty.

What happens during an exercise ECG?

  1. Electrodes are attached to your shoulders and chest and connected to an ECG recorder.
  2. You will be asked to walk on the treadmill or use the pedals on a stationary exercise bike, starting off at a slow, comfortable pace.
  3. The test will get gradually harder by increasing the speed on the bike or the incline of the treadmill.
  4. You will be encouraged to work as hard as you can, but tell the healthcare professional assessing you if you start getting chest pain or discomfort, or you get tired or very short of breath and the test can be stopped.
  5. You will be carefully monitored throughout the test and the technician will tell you when to stop.

The test usually takes around fifteen minutes in total.  

What if the exercise is too hard?

An exercise ECG will probably make your heart work harder than normal, but the healthcare professional will not make you exercise beyond your ability. 

How can I prepare for an exercise ECG?

  • Wear light, comfortable clothes and shoes.
  • Avoid having a heavy meal a few hours before the test.
  • If you take beta blocker medication (such as bisoprolol) you will be advised to stop taking it for one or two days before the test as it may affect the result.

Want to find out more? Tests booklet

Tests for heart conditions booklet

This booklet describes the special tests that are commonly used to help diagnose heart diseases.

Some of the tests are also used to assess the current condition of people who have already been diagnosed with heart disease.