Treadmill exercise test

Treadmill exercise test


Treadmill exercise test is also known as stress test, stress ECG, treadmill test, TMT, exercise treadmill test etc. Exercise is one of the ways to stress the cardiovascular system and ECG is one of the means for assessing the ischemic response of the myocardium.
prestest

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Pretest ECG is taken to assess the baseline status of the subject. If there is any fresh change or serious arrhythmia, the test is postponed. Some changes from the conventional ECG is expected as the limb electrodes are placed on the torso rather than on the extremities. There will be a mild rightward shift of the axis and hence Q waves in the inferior leads may diminish or disappear. Basal heart rate and blood pressure are printed on the pretest ECG.
In standard Bruce protocol for treadmill exercise test, the speed and gradient increases every three minutes. Hence the ECG is recorded at the end of two minutes in each stage to achieve a steady state at that particular level of exercise.

The summary page shows all the stages including recovery, the speed and gradient in each stage, heart rate and the METS achieved. 1 MET is the basal metabolic equivalent and corresponds to 3.5 ml/kg/min of oxygen utilization. Rate pressure product (product of systolic pressure and heart rate, also known as double product) is also displayed if the blood pressure is entered.
peak-exercise

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The peak exercise tracing shows the maximum heart rate achieved and ischemic changes if any. Recordings during recovery may pick up the persistence of ischemic changes or new ischemic changes which may sometimes occur during recovery. The peak exercise capacity measures the functional status of the individual, higher the exercise capacity, better the prognosis.

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