​Children's Heart Center

Exercise Testing

An exercise test is performed by a specially trained doctor, nurse or exercise physiologist to assess the heart’s response to stress or exercise. It can also be used to assess patient’s symptoms or to monitor their cardiac status over time following heart surgery. The procedure is typically performed in a physician’s office, clinic, hospital or medical center.

During the test, an ECG (also called EKG) is monitored while the patient is exercising on a treadmill or stationary bike. An EKG tracing and blood pressure measurement will be taken at certain points during the test to compare the effects of increasing stress on the heart.

Exercise testing may also be combined with another diagnostic test called an echocardiogram. The echocardiogram is used to assess the structure and function of the heart during exercise. When these two tests are combined it is called a stress/echocardiogram. This testing is used in specific patient populations to assess heart function or blood flow dynamics through valves while the heart is beating faster from exercise, thus adding information to the initial electrical results from the EKG.

Additional equipment may be used in specific patients to assess their breathing at rest or during exercise. A resting spirometry test (also called pulmonary function test) is performed to measure the size and strength of the lungs and rule out potential signs of asthma or lung disease. The spirometry test is performed by forcefully blowing out one breath for as long as the patient can until all the air is expelled from his or her lungs. This single breath effort may be repeated to obtain the best reproducible efforts and lung values.

Performing an Exercise Test

  • Staying hydrated and eating a light meal or snack prior to the test is recommended.
  • The patient will have initial, or “baseline,” EKG and blood pressure readings done prior to exercising.
  • In some cases, a snorkel-style mouthpiece may be placed prior to starting the treadmill or stationary bike to measure every breath a patient takes with exercise. This provides information on how efficient the heart and lungs are working together under stress.
  • The patient will walk on the treadmill or pedal the bicycle during the exercise portion of the procedure. The incline of the treadmill or the resistance of the bicycle will be gradually increased to give the patient a harder workout.
  • The patient will exercise until reaching a target heart rate (determined by the physician based on age and physical status) or until the patient is unable to continue due to fatigue, shortness of breath, chest pain, irregular heart rhythms or other symptoms.
  • EKG and blood pressure will be monitored during the exercise portion of the test. The patient will then sit after exercising while EKG and blood pressure are monitored for a short time, about five to 10 minutes.
  • The procedure will take approximately one hour, including check-in and preparation.
  • After the procedure, a hospital stay is unnecessary, unless the physician determines that the condition requires further observation or hospital admission.
  • The patient may feel a little tired or sore for a few hours after the procedure, particularly if he or she is not used to exercising. Otherwise, the patient should feel normal within a few hours after the procedure, if not sooner.
  • Depending on the results of the exercise test, additional tests or procedures may be scheduled by the physician to gather further diagnostic information.