Exercise (stress) ECG

An exercise ECG, also referred to as a stress ECG, involves patients undergoing strenuous exertion, typically via a treadmill or static bike and examines the heart’s electrical activity when under strain. Although a patient’s ECG may be normal at rest, once put under stress, the heart can develop electrical abnormalities.

All our Exercise ECGs are carried out by experienced and qualified Doctors – Discover more about this procedure and what to expect when visiting an EchoMed clinic below.

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woman stretching in gym attire

What is an exercise echocardiogram?

An exercise ECG, also known as a stress ECG, examines the heart’s electrical activity during exertion, and although a patient’s ECG may be normal at rest, once put under strain, the heart can develop electrical abnormalities. 

Furthermore, in those patients with a prior history of cardiovascular disease, this test can be performed to look for evidence of a blocked coronary artery and also be used to exclude exercise-induced arrhythmias.

man wearing a face mask looking at a heart monitor

What happens during an exercise echocardiogram?

An exercise or stress ECG requires patients to attempt strenuous exertion using a treadmill or static bike. As such, patients will be required wear clothing and footwear that are comfortable to exercise in. 

Patients are welcome to get changed after they arrive at the EchoMed clinic if they prefer.

Your Doctor will attach ECG leads and a blood pressure cuff, allowing them to monitor you throughout your test. They will stop the treadmill if any worrying abnormalities [AS1]  appear, and you are also free to stop at any time during the test in the event of fatigue.

treadmill used for exercise stress ECG

The EchoMed experience

At EchoMed, we deliver an industry-leading level of service, ensuring as relaxing and comfortable an experience as possible. Our stress echocardiograms use specialist treadmills, enabling patients to complete the Bruce protocol, a standardised exercise programme in which the treadmill’s incline and speed increase every three minutes.

Most patients will find stage one of the Bruce protocol very easy, with stage three being the equivalent of a steep, brisk walk, then moving onto stage four, which is a jog, and ultimately getting onto stage seven, a very strenuous run at 22% incline.

The goal of the test is not to finish the entire protocol (which is very rare), but rather to achieve a target heart rate, after which point the test can be terminated.

An illustration of two doctors having a conversation and holding notes.

What does a stress echocardiogram test for?

While a stress ECG is not the gold standard for coronary artery disease, it can still be an advantageous non-invasive assessment of coronary blood flow, especially in people with known cardiovascular disease, such as a previous history of heart attack or stent. 

During exertion, a narrowed coronary artery may restrict blood flow to the heart muscle, depriving it of oxygen. This process, known as Ischaemia, can produce important ECG changes, such as ST depression, T wave inversion, or ST elevation, which are detected during an exercise test using bespoke software. If these ECG changes occur, our Doctor will refer you for further investigation, which may include a CT scan or Angiogram.

Exercise can provoke numerous heart abnormalities, hence the reason why exercise ECGs are also helpful in those with exertional palpitations or a family history of sudden death during exercise. 

A woman wearing a hat, running with a sunset in the background.

Who needs this procedure?

An exercise ECG has a broad range of applications, predominantly in testing patients with exertional symptoms, such as palpitations or dizzy spells. However, patients without symptoms who are planning significant increases in their exercise regime, e.g. marathon training, or those with a suspicious family history, may wish to consider an exercise ECG to examine their heart’s performance under strain.

Importantly, the Bruce protocol is recognised by numerous national regulatory bodies, such as TFL, the DVLA, and the CAA, meaning an exercise ECG may be a requirement for a taxi driver or pilots who need medical clearance as a condition of their employment.

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The next steps after your echocardiogram test

Your Doctor will be able to provide you with the results at the end of your test, and should any abnormalities be detected, such as ECG changes suggestive of a blocked coronary artery, we can arrange for you to have further investigation, like a CT coronary angiogram. We can arrange this via your NHS GP or privately, according to your preference.

Book an appointment

In just a few clicks, you can arrange an appointment that suits you. Book with EchoMed today. Whether you are concerned about unexplained symptoms, or simply wish to exclude any problems which may cause trouble later in life, our scans can help.

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How To Find Us

Our Surrey Hills (Farnham) clinic is conveniently located just off the A31. We are situated inside the Carlton Yard Clinic (postcode: GU9 7RD), which can be accessed on foot off the southwest corner of Farnham Central Car Park.

From the car park, you will see a selection of signs attached to the exterior wall of the Carlton Yard Clinic (including ‘EchoMed: The Cardiac Ultrasound Clinic’). Walk around the left-hand side of this building, turn right in front of The Silver Sea restaurant, and continue through an archway with a metal gate. This gate is usually open – if not, please buzz the intercom and our team will assist you. The wooden door to the Carlton Yard Clinic is through this arch and immediately on the right.

Our South Coast (Emsworth) clinic is within minutes of the A27. We are situated on the ground floor of the Hampshire Health building (97 Havant Road, postcode: PO10 7LF), which offers free parking to the rear. On arrival, our receptionists will show you to the waiting area.

If you have any issues finding either of our clinics, please call 0333 444 3246 for assistance.


Hampshire Health

97 Havant Road, Emsworth

PO10 7LF



The Carlton Yard Clinic, Unit 1, Carlton Yd,

Victoria Rd, Farnham


0333 444 3246

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