Expert London Cardiologist for your Heart Health

Exercise Stress Testing

Exercise Tolerance Testing (ETT)

A treadmill stress test

An exercise tolerance test involves running on a treadmill.

It can be used to look for angina, arrhythmia, and hypertension.

An exercise tolerance test (ETT) is a test of your cardiovascular fitness. You will be asked to run on a treadmill while your heart rate and blood pressure are closely monitored.  A continuous tracing of the electrical activity of your heart is made.


An ETT may be used this test to assess the control of your heart rate and blood pressure under strain, and he may use it to detect or monitor angina (pains from the heart).

“This test can be really useful to understand what symptoms occur on exertion, to monitor the response to stenting or bypass surgery and to unmask arrhythmias.  Although current guidelines don’t suggest using it as a single rule-out test, it does still have great utility in helping to identify problem areas when used in conjunction with other tests. There is a wealth of prognostic data from the simple treadmill test “

The purpose of the treadmill test is to see what exertion symptoms happen in a controlled environment.  ECG and blood pressure changes can occur even before symptoms, and sometimes even subtle changes can help lead to treatment changes.

The key to a high quality exercise stress test is to achieve the maximum target heart rate.  In younger people this can be more challenging but the test is designed to become progressively harder.  In those who take medications that limit their heart rate, such as patients with angina who take beta-blockers, its important to stop the medication 48 hours prior to the test.  Example beta-blockers include bisoprolol, carvedilol, metoprolol and atenolol.

Before we undertake an ETT, we may need to undertake an echocardiogram to ensure the heart structure is normal.  

If there are certain changes on the ETT – those raising suspicion of angina or ‘ischaemic heart disease’, it may be appropriate for you to undergo a coronary angiogram.


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Dr Sukhjinder Nijjer Consultant Cardiologist

One Heart Clinic
27 Harley Street
London, W1G 9QP

0203 9838 001

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