Exercise Electrocardiogram

Overview

What is an Exercise Electrocardiogram?

An EKG is one of the simplest and fastest procedures used to evaluate the heart. Electrodes (small, plastic patches) are placed at certain locations on your chest, arms, and legs. When the electrodes are connected to the EKG machine by lead wires, the electrical activity of your heart is measured, interpreted, and printed out for the physician's information and further interpretation.

An exercise EKG is performed to assess the heart's response to stress or exercise. The EKG is monitored while you are exercising on a treadmill or stationary bike.

An EKG tracing will be taken at certain points during the test in order to compare the effects of increasing stress on the heart. Periodically, the incline and treadmill speed will be increased in order to make you exercise harder. If you are riding a bicycle, you will pedal faster against increased resistance. You will exercise until you reach a target heart rate (determined by the physician based on your age and physical status) or until you are unable to continue due to fatigue, shortness of breath, chest pain, or other symptoms.

Reasons for the Procedure

As previously mentioned, some reasons for your physician to request an exercise EKG include, but are not limited to, the following:

• to determine limits for safe exercise in patients who are entering a cardiac rehabilitation program and/or those who are recovering from a cardiac event, such as MI or heart surgery
  
  
• to assess leg pain with exercise (also called intermittent claudication) in patients with suspected occlusion in the legs' circulatory system
  
  
• to evaluate blood pressure during exercise
  
  
• to assess stress or exercise tolerance in patients with known or suspected coronary artery disease

Risks of the Procedure

Because of the stress the heart incurs during the procedure, there is a small chance for chest pain, heart attack, high blood pressure, irregular heartbeats, dizziness, nausea, and extreme fatigue. Notify your physician if you have the following conditions:

• aneurysm - a dilation of a part of the heart muscle or the aorta (the large artery which carries oxygenated blood out of the heart to the rest of the body) which may cause a weakness of the tissue at the site of the aneurysm. In extreme cases, the aneurysm may rupture, which is an emergency situation, due to rapid blood loss out of the blood vessels.
  
  
• unstable angina (uncontrolled chest pain)
  
  
• severe heart valve disease
  
  
• severe congestive heart failure
  
  
• recent myocardial infarction (also called MI, or heart attack)
  
  
• severe hypertension (high blood pressure)
  
  
• uncontrolled irregular heartbeats
  
  
• pericarditis (an inflammation of the heart)
  
  
• severe anemia (low red blood cell count)

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