Stress Exercise

Exercise Treadmill ECG Test (TMX)

To better understand your symptoms, visit us for a comprehensive diagnosis and personalised treatment plan.

What is Exercise Treadmill ECG (TMX)?

An Exercise Treadmill ECG test is one of the most common stress tests performed to evaluate the heart’s response to physical stress. The test involves walking on a treadmill at gradually increasing speeds and inclines. This makes your heart pump harder and faster, and may uncover problems within your heart that might not be detected otherwise.

What is the purpose of an Exercise Treadmill ECG?

The coronary arteries are the blood vessels that supply the heart muscles with oxygen-rich blood. When the coronary arteries are narrowed, the heart muscles may only receive enough blood supply in the resting state. However, during exercise stress, the blood flow may be insufficient to meet the increasing oxygen demands of the heart muscles. This lack of blood supply causes symptoms such as chest pain (also known as angina) or shortness of breath, and may be a warning sign of a heart attack.

Exercise Treadmill ECG is a simple and safe test to detect the lack of blood flow to the heart muscles due to severe narrowing of the coronary arteries.

What is the Cause of Narrowed Coronary Arteries?

Coronary artery disease develops when the arteries that supply blood to your heart become narrowed or blocked by a build-up of fatty cholesterol deposits called plaque. This process is known as atherosclerosis and develops over time.

Normal Artery vs Atheroclerosis
Why do I need an Exercise Treadmill ECG?

Your doctor may suggest an Exercise Treadmill ECG for the following reasons:

  • Determine if your symptoms are caused by coronary artery disease
  • Determine how well your heart tolerates activity
  • Assess how your heart rate and blood pressure respond to exercise
  • Assess for any exercise-induced heart rhythm abnormalities
  • Evaluate your condition following a cardiac procedure
  • Evaluate the effectiveness of your cardiac treatment plan
  • You may have significant risk factors for coronary artery disease such as smoking, high cholesterol or high blood pressure
What happens during an Exercise Treadmill ECG?
Placement of electrodes for Treadmill ECG
  • You will be asked to undress from the waist up. You will wear a gown for the procedure.
  • Electrodes, which are small sticky patches, are placed on your chest. These patches are connected to an ECG machine that monitors your heart rhythm throughout the test. Sometimes, shaving of the chest hair may be necessary for the electrodes to stay in place.
Treadmill ECG Capital Heart Centre
  • Under continuous supervision of our staff, you will start walking on the treadmill, which is programmed to get steeper and faster every 3 minutes.  Your blood pressure and heart rate will be measured throughout.
  • Once you have reached a set heart rate target, or if you develop symptoms that do not allow you to continue, the treadmill will stop.
  • After the exercise treadmill is stopped, you will rest on a chair during the recovery stage while your heart rate, blood pressure and ECG is being continuously monitored for another 5-10 minutes.
  • If you have any symptoms such as chest pain or shortness of breath at any time, or are unable to progress with the test, you must inform us immediately.

The whole process may take about 60 minutes, but the actual exercise time usually lasts only 6 to 12 minutes.

Are there risks involved in an Exercise Treadmill ECG?

Treadmill exercise is very safe and side effects are uncommon. Some of the potential risks are:

  • Chest pain
  • Breathlessness, dizziness, fainting
  • Abnormal heart rhythm (0.1%)
  • Heart failure
  • Heart attack (0.4%)
  • Death (0.01%)
  • Muscle/joint injury, fall from the machine
How should I prepare for an Exercise Treadmill ECG?

Before your Exercise Treadmill ECG, you should do the following:

  • Do not eat or drink anything for at least 2 hours before the test.
  • Avoid foods containing caffeine for 24 hours before the test, including chocolates, tea and coffee (including decaf). Caffeine can affect your heart rate and interfere with the results.
  • Do not smoke or consume alcohol on the day of the test.
  • Wear comfortable, loose-fitting clothes.
  • Wear comfortable shoes. You should be able to do the test if you can walk easily or walk briskly.
Treadmill ECG CHC
What do I need to tell my doctor before undergoing an Exercise Treadmill ECG?

It is important to tell your doctor about any other medical conditions you have (such as mobility issues), or if you are feeling unwell.

If you use an inhaler for asthma or other breathing problems, please bring it along with you.

Do I need to stop any medications before undergoing an Exercise Treadmill ECG?

If you take medications that slow down your heart rate (such as beta-blockers or calcium channel blockers), you need to stop taking them 24 hours before your Exercise Treadmill ECG Test. These medications will interfere with the results of the test. You may consume all your other regular medications.

Please check with your doctor to see if you need to stop any of your medications.

When will I know the results?

Your cardiologist will usually be able to tell you the preliminary results of the Exercise Treadmill ECG. A detailed review of the results and findings will be discussed with you during your next follow-up appointment. You may be contacted earlier if urgent care is required for your condition. Further tests may be recommended if abnormalities are detected.

How can we help you?

We offer consultation for a comprehensive range of cardiac diagnostic tests and treatment plans.

Dr Joshua Loh

Senior Consultant Interventional Cardiologist

Medical Director at Capital Heart Centre, Dr Joshua Loh has more than 15 years of experience in the field of cardiology.

He is experienced in the treatment of complex coronary and interventional procedures.



How can we help you today?

× Contact Us