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Also known as the cardiac treadmill test, stress test or exercise electrocardiogram (ECG), the treadmill test is a diagnostic procedure used to evaluate how well the heart responds to stress or exercise. Sometimes it may be paired with a stress echocardiogram (heart ultrasound scan).

It can be used to assess a patient with known or suspected heart disease as it can uncover the presence of coronary artery disease, abnormal heart rhythms, or other heart conditions. In the athletic population, it is also used as a screening test for clearance to participate in extreme sports and activities.

If you suspect that you have a heart problem, the first step should be a discussion with your doctor to discuss which test is most appropriate for you. This test does not fully exclude the presence of coronary artery disease, abnormal heart rhythms, and structural heart problems such as valve dysfunction.

What happens during the test?

Before the test, we need to obtain a baseline resting ECG from the patient, and check for abnormal electrical activity which may increase the risk of undertaking a stress test. Next, the patient walks on a treadmill while their heart rate, blood pressure, and ECG are monitored. The speed and incline of the treadmill are gradually increased to see how the heart responds to exertional stress. The test aims to assess the electrical activity of the heart at 85% of its maximum capacity. It may be terminated early due to patient fatigue or concerning symptoms. After 85% heart rate is achieved, there is a period of cooling-down and rest prior to the end of the test.

Patients will be monitored after the stress test to ensure that their heart rate and blood pressure return to regular readings before we can discharge the patient. We have a shower facility if patients would like to shower before leaving the clinic.

Once the report is received, the doctor will inform the patient of the test outcome; if the results are abnormal, the doctor will discuss a treatment plan with you and may refer you to a cardiologist for further management. A negative (normal) treadmill test in a patient without sinister risk factors or symptoms generally indicates that the patient is not at increased risk for cardiac events during intensive exercise.

Possible risks from this test include falls,injuries, heart issues associated with intensive activity (abnormal heart rhythm, chest pain, heart attack and cardiac arrest), as well as dizziness or fainting.

What are the alternatives to running?

There are other tests available for patients who are unable to run on a treadmill, their physician may recommend other modalities of testing including bicycle exercise stress testing, or chemical stress testing (where a medication is injected to stress the heart). Other modalities to assess the heart include echocardiography, CT scanning (calcium score, coronary angiograms), nuclear imaging (MIBI scan), cardiac MRI and coronary catheterisation. Each of these have their own advantages and considerations depending on the patient’s specific circumstances.

The treadmill stress test is available at IMC Camden, 1 Orchard Blvd, #14-05/06/07 Camden Medical Centre, Singapore, 248649.

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 International Medical Clinic

Book an appointment at https://www.imc-healthcare.com/locations/camden/