How is a stress test performed?

During a stress test, you will be asked to walk on a treadmill or take medications to make your heart simulate the work it does with exercise. Be sure to follow any food and drink guidelines that your physician gives to you to prepare for the test. Wear shoes and clothing that are appropriate for walking on a treadmill.
While you walk, electrodes (sticky patches) that are attached to your chest and limbs send signals to an electrocardiogram (ECG/EKG) machine, which creates a readout of the heart’s electrical activity. The continuous recording from the electrocardiogram taken during the stress test evaluates if there are any changes consistent with a portion of the heart not receiving enough blood flow. Whether you feel chest pain or other symptoms when your heart is “under stress” may indicate to your doctor the presence of any blockages in the arteries that supply blood to your heart.
In addition to the continuous recording of the electrocardiogram, your doctor may obtain images during the stress test through an echocardiogram (ultrasound) to assess the flow of blood. You may also receive a nuclear stress test, for which a small amount of radioactive tracer will be injected into your bloodstream. These imaging tests may be needed for some patients to increase the accuracy of the stress test.

The most common type of stress test involves walking or running on a treadmill while an electrocardiogram (ECG) records the electrical activity in your heart. To prepare for this type of stress test, a nurse or technician will put sticky electrode patches on your chest, arms and legs. (Men who have a lot of chest hair should be prepared to be shaved in spots.)


The electrodes are connected by wires to an ECG machine, which keeps track of how fast your heart is beating, whether the rhythm is steady or irregular and any abnormal electrical patterns indicating that your heart is not getting enough blood flow or has been damaged by a previous heart attack. You will also have a blood pressure cuff on your arm that inflates periodically to make sure your blood pressure does not go too high or too low.


When you first start exercising on the treadmill, it may not seem like much work, but every few minutes the intensity goes up, as the speed and incline of the treadmill increase. Some exercise tests use a stationary bicycle instead of a treadmill. If you cannot exercise, you may instead be given a medication that makes your heart pump harder and faster, and mimics the effects of exercise.


Typically, you will continue with the stress test until you reach a target heart rate or a problem develops indicating that you should stop. For example, the stress test can be stopped if you feel too exhausted to continue, develop chest pain or abnormalities on the ECG, feel faint or dizzy or your blood pressure goes too high or too low.


After the stress portion of the test, you will go into a cool-down phase. The nurse or technician will continue to monitor your ECG and blood pressure, until they are back to normal.


Continue Learning about Heart and Circulatory System

Heart and Circulatory System

Heart and Circulatory System

Your circulatory system is made up of your heart and three main types of blood vessels -- arteries, veins and capillaries. Your heart is at the center of the system, acting as a pump to distribute nutrient- and oxygen-rich blood t...

hrough your body; it then takes away carbon dioxide and other waste your body doesn't need. Signs of poor circulation include cold hands and feet, numbness, dizziness, migraines, varicose veins and pain in your feet or legs. Untreated, poor circulation can lead to stroke, high blood pressure, kidney damage and other diseases. Learn more about your heart and circulatory system with expert advice from Sharecare.

Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.