Heart Disease Health Center

How To Prepare

Tell your doctor if you:

• Are taking any medicines, including a medicine for an erection problem (such as Viagra). You may need to take nitroglycerin during this test, which can cause a serious reaction if you have taken a medicine for an erection problem within the previous 48 hours. Ask your doctor whether you need to stop taking any of your other medicines before the test.
• Are allergic to any medicines, such as those used to numb the skin (anesthetics).
• Have had bleeding problems or take blood-thinners, such as aspirin or warfarin (such as Coumadin).
• Have joint problems in your hips or legs that may make it difficult for you to exercise.
• Are or might be pregnant.

Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results will mean. To help you understand the importance of this test, fill out the medical test information form(What is a PDF document?).

Your doctor may recommend how you should eat before the test. For example, your doctor may suggest you only eat a light breakfast before your test.

An exercise EKG may be dangerous and should not be done in some situations. Be sure to tell your doctor if you:

• Think you are having a heart attack.
• Are having chest pain that is not relieved with rest (unstable angina).
• Have high blood pressure that is not controlled with medicine.
• Have untreated, life-threatening irregular heart rhythms (arrhythmias).
• Have severe narrowing of one of your heart valves (aortic valve stenosis).
• Have an infection in your heart muscle (myocarditis).
• Have a severe decrease in the amount of red blood cells (anemia).
• Have a stretched and bulging section in the wall of the large artery that carries blood from the heart (aortic aneurysm) or in one of the chambers of the heart (ventricular aneurysm).
• Have severe lung disease.

Remove all jewelry from your neck, arms, and wrists. Wear flat, comfortable shoes (no bedroom slippers) and loose, lightweight shorts or sweat pants. Men are usually bare-chested during the test. Women often wear a bra, T-shirt, or hospital gown. Avoid wearing any restrictive clothing other than a bra.

You may want to stretch your arm and leg muscles before beginning an exercise EKG.

How It Is Done

An exercise electrocardiogram (EKG or ECG) is usually done in a doctor's office, clinic, or hospital lab by a health professional or doctor. The test results are evaluated by an internist, family medicine doctor, or cardiologist.

Before the test

• Areas on your arms, legs, and chest where small metal discs (electrodes) will be placed are cleaned and may be shaved to provide a clean, smooth surface to attach the discs. A special EKG paste or small pads soaked in alcohol may be placed between the discs and your skin to improve conduction of the electrical impulses, but in many cases disposable discs are used that do not require paste or alcohol.
• The electrodes are hooked to a machine that traces your heart activity onto a piece of paper. Your chest may be loosely wrapped with an elastic band to keep the electrodes from falling off during exercise. A blood pressure cuff will be wrapped around your upper arm so that your blood pressure can be checked every few minutes during the test.

During the test