Stress Electrocardiogram (ECG): an overview of the test

By Cristiano Antonino On Dec 12, 2022

What is a stress electrocardiogram (ECG)? The electrocardiogram or ECG is a diagnostic test performed to record the electrical activity of the heart, so that its general state of health can be assessed and various cardiac conditions, sinus rhythm arrhythmias or heart disease can be detected

The investigation is carried out using an instrument called an electrocardiograph, which is able to record the heart function and reproduce it graphically in the form of a trace.

Depending on the case, a cardiologist may prescribe different types of ECG, which differ mainly according to the specific function and how they are performed: the standard or resting ECG, the dynamic ECG according to Holter, and the exercise ECG or ergometric test.

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Resting electrocardiogram: used to record cardiac function under normal conditions

It involves placing 12 to 15 electrodes on the patient’s chest, arms and legs; the test usually lasts a few minutes, during which all that is required is to lie still, breathe regularly and avoid talking or moving.

Stress electrocardiogrph: assesses ECG changes during physical activity

It is also used to assess cardiac behaviour when subjected to exertion; after placing the electrodes, the patient is generally asked to pedal on an exercise bike or run on a treadmill for 5 to 20 minutes to take the measurement.

Dynamic electrocardiogram according to Holter:

This is performed to monitor heart function over a longer period of time, usually 24 – 48 hours; it is usually prescribed to diagnose arrhythmias of a discontinuous character, which would not be detected by a standard ECG.

To perform the examination, electrodes are attached to a portable device that records cardiac activity and allows the tracing to be extrapolated later.

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Why is the stress electrocardiogram performed?

The stress test is used to monitor cardiac function when subjected to intense physical activity: it allows variations in the number of beats and alterations in cardiac rhythm to be detected; the examination involves performing simple physical exercises, or the administration of specific drugs suitable for simulating the effects of stress.

At the physician’s request, oxygen consumption may be prescribed during the exercise ECG in order to assess the change in blood pressure levels and monitor the pulmonary response related to respiratory function.

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The exercise ECG makes it possible to examine the reactions of the cardiovascular system and diagnose any abnormalities that would not be detected under normal conditions

In particular, it is indicated for the in-depth study of

ischaemic heart disease
arrhythmias;
arterial hypertension;
angina pectoris;
assessing the effectiveness of interventions such as angioplasty and bypass;
in some cases, this investigation is prescribed to assess the effects of certain drugs on the heart.

Stress Electrocardiogram (ECG): How should I prepare?

The ECG is a non-invasive examination that poses no risk to the patient and requires no special preparation.

Some useful precautions may be

wear comfortable clothing that allows freedom of movement;
perform the test on an empty stomach for at least 2-3 hours;
avoid alcohol or caffeine;
abstaining from smoking;
do not engage in strenuous sport in the 4-5 hours preceding the test;
take any medication regularly, unless otherwise instructed by your doctor.

*This is only indicative information: it is therefore necessary to contact the facility where the examination is being performed to obtain specific information on the preparation procedure.

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