Stress ECG

What is a stress ECG?

In a stress ECG, the doctor uses electrodes to derive the electrical heart actions while the patient is doing physical activity. This makes it possible to identify certain cardiovascular diseases, such as coronary heart disease, and to make statements about the individual physical fitness of the patient.

When is a stress ECG done?

Some heart diseases only show up during physical exertion. In coronary heart disease (CHD) in particular, the resting ECG is often inconspicuous. In stress ECG, on the other hand, the disease can be diagnosed through rhythm disturbances or ECG changes. Other reasons for a stress ECG include:

• Control after heart attack or bypass surgery
• Exercise-related heart rhythm disorder
• Follow-up assessment of a treated rhythm disorder
• hypertension
• Assessment of individual performance
• Monitoring the success of drug treatment (e.g. against high blood pressure)

Procedure of a stress ECG

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

• 25 to 50 watts: normal walking
• 75 to 100 watts: climbing stairs or cycling slowly
• 125 to 150 watts: jogging or fast cycling
• over 150 watts: heavy sporting load

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

Evaluation of stress ECG

In addition to performance — measured in watts — the practice also checks patients' subjective performance. During the examination, people also provide feedback on their perception of the severity of 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 exertion. In order to determine the individual target value of performance, the doctor uses the following rule of thumb during an exercise ECG: The number of years a person has lived is deducted 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 for patients who have coronary Heart disease is not yet known and/or who have no symptoms, but the stress ECG can also provide false normal findings. This means that there are no abnormalities even though the person has CHD. That is why doctors supplement the Stress ECG usually for further investigations.

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How do I get a stress ECG with avi?

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