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What is a stress ECG?

With a stress ECG, the doctor records the electrical heart actions using electrodes while the patient is moving physically active. This allows certain cardiovascular diseases such as coronary heart disease to be diagnosed and statements to be made about the patient's individual physical fitness.

When is a stress ECG done?

Some heart diseases only become apparent during physical exertion. The resting ECG is often normal, especially in coronary heart disease (CHD). In the stress ECG, however, the disease can be diagnosed through rhythm disturbances or ECG changes. Other reasons for a stress ECG are:

  • Check after a heart attack or bypass operation
  • Stress-related cardiac arrhythmia
  • Assessment of the course of a treated arrhythmia
  • High blood pressure
  • Assessment of individual performance
  • Control of the success of drug treatment (e.g. against high blood pressure)

Procedure of a stress ECG

As with the resting ECG, the doctor sticks electrodes to the patient's skin or the patient and connects it to an ECG device via cable. This 12-channel ECG records the heart's action while the patient is physically active, for example on a treadmill or a stationary bike (bicycle ergometer). Different stress phases can be set on the sports equipment, which correspond to the physical stress in everyday life:

  • 25 to 50 watts: normal walking
  • 75 to 100 watts: climbing stairs or slow cycling
  • 125 to 150 watts: jogging or fast cycling
  • over 150 watts: heavy sporting activity< /li>

The load is increased by 25 watts every two minutes. The exercise ECG duration is approximately 15 minutes. If there are dangerous ECG changes, an excessive increase in blood pressure (>250 mmHg systolic and >120 mmHg diastolic) or if the patient experiences any symptoms, the doctor will stop the stress ECG immediately. Otherwise, the wattage continues to increase until the maximum heart rate (=220 minus age) is reached or the person is exhausted. After the exercise, the patient is observed for another six minutes to assess the drop in heart rate.

Evaluation of the exercise ECG

In addition to the performance – measured in watts – the practice also checks the patients’ subjective perception of performance. During the examination, the person provides feedback about their perception of the severity of the stress. Blood pressure and heart rate are also determined for monitoring and diagnostics.

The heart rate at rest is 60 to 80 beats per minute and naturally increases under physical stress. In order to determine the individual target value of performance, the doctor uses the following rule of thumb for the stress ECG: The number of years of life of the person is subtracted from a heart rate of 220 beats per minute. This results in its load limit.  

If the patient suffers from heart disease, you can often see typical changes in the ECG. Especially in patients for whom coronary heart disease is not yet known and/or who have no symptoms, the stress ECG can also provide false normal findings. This means that there are no abnormalities, even though the person has CHD. That's why doctors usually supplement the stress ECG with further examinations.

How do I get one Stress ECG at Avi Medical?

You cannot book a stress ECG directly at one of our practices. This is usually done in connection with an examination of coronary heart disease or a suspicion of it.