Exercise tolerance test

Patient Information Leaflet

Introduction 

You have been given this leaflet as your GP or hospital consultant has suggested you would benefit from having an exercise tolerance test. This leaflet gives more information on what this involves.

If you have any questions or concerns, please do not hesitate to contact a member of the Cardiology Department.

What is an exercise tolerance test (ETT)?

An ETT is sometimes also called a Stress Test or Treadmill Test. It is a test that measures your cardiac response to exercise and the changes in your blood pressure or heart’s electrical pattern (ECG), during the exercise.

What are the benefits?

It is a test to see how your heart copes during physical activity and how well it recovers from exercise. It will provide your doctor with important information about the health of your heart.

What are the risks?

Your doctor will only recommend this test if they think it is suitable for you.

The exercise workloads start at very low levels and, because you are monitored throughout, the test can be stopped immediately if you become distressed or if the recordings are unfavourable.

Very rarely, some people may have a problem with the rate and rhythm of their heartbeat, or cardiac arrest during the test. Your heart is monitored at all times and in the unlikely event of any problems, there is an emergency stop button on the treadmill. All the staff are trained in emergency procedures.

Are there any alternatives to this test?

This may be one of a number of tests suggested to diagnose your condition. It is your choice as to whether you have the test.

Can I eat before the exercise test?

You can have a light meal two hours before the test. After this, do not eat again until after the test. If you have diabetes, contact us if the appointment is at a difficult time and we will rearrange your test to suit you.

What about medications?

You can take any medications you are currently prescribed as usual on the day of the test, unless we tell you not to. Please bring your medicines or a list of your medicines to the appointment.

What should I wear?

Wear comfortable, loose-fitting clothes and flat-heeled, firmly fitting shoes. Trousers are more practical than skirts. You can wear sportswear, if you prefer, but please do not buy sportswear especially for the test. This is not necessary.

How do I exercise during the test?

A treadmill or a cycle ergometer is used for the exercise during the test.

What is a treadmill?

It is an electronically controlled, moving belt that you walk on in a precise and careful manner. Work effort is increased by raising the incline and/or the speed of the belt, in small steps.

What is a cycle ergometer?

It is a fixed seat with foot pedals. Some look like a standard bicycle while others look more like a couch with pedals. Workload is increased by applying a braking system to the wheel as you pedal.

Whichever is used, we will train you how to use it and you will have a chance to practise before the test.

What happens when I come for the test?

Your height and weight will be measured. This is needed to assess the levels of work achieved during the test.

We will take you to a curtained area and ask you to remove any clothes above the waist. This is necessary so that the cardiac physiologist can put sticky electrodes on your chest to record your ECG (electrocardiogram) correctly. The sticky pads used for this are larger and more adhesive than for a standard ECG to ensure they do not slip during the test.

The cardiac physiologist will need to lightly rub the skin or sometimes shave off a little chest hair so the electrodes can stick well. The electrodes on your chest are attached via leads to a module that is on a belt around your waist. This is then connected via another cable to the exercise machine that the physiologist controls and monitors.

If you prefer a female or male member of staff, or a chaperone for this procedure, please ask.

How long does the test take?

This will depend on what you are capable of in terms of exercise and the instructions from your doctor. Overall the whole procedure, which includes a short rest period after exercise, should take about half an hour.

What happens after the test?

You can go home as soon as you feel ready and continue with your normal activities, but we would ask that you do not do any strenuous exercise for the rest of the day so you can recover from the test.

How do I get the results?

We will send your report back to your GP or hospital consultant who asked for the test. They will be in touch with you to discuss the results.

If you have any questions, or if there is anything you do not understand, please contact the Russells Hall Hospital switchboard number on 01384 456111 and ask for the relevant department who issued this leaflet. If you have any feedback on this patient information leaflet please email dgft.patient.information@nhs.net

This leaflet can be made available in large print, audio version and in other languages, please call 0800 073 0510.

Originator: Cardiology Department. Date reviewed: August 2025 Next review due: September 2028. Version: 5. DGH ref: DGH/PIL/00432.