Exercise Tolerance Test

An exercise tolerance test (ETT) is helpful in evaluating a patient's heart function during exertion, and detecting the presence of coronary artery disease and arrhythmias.

During an ETT, a patient exercises on either a treadmill or a stationary bike (cycle ergometer), and the intensity of the exercise is gradually increased until the patient becomes fatigued. Blood pressure, breathing, and heart rate are monitored throughout the test, which is administered by a clinical exercise physiologist and a physician. In some cases, oxygen saturation also is monitored. If a patient cannot exercise adequately on a treadmill, medications can be used to simulate exercise.

Brigham and Women's Hospital (BWH) offers one of the few multidisciplinary noninvasive cardiovascular imaging programs in the country that includes cardiologists, radiologists, and other imaging experts. The BWH Cardiovascular Imaging Program combines the treatment, education, and research expertise of multiple disciplines – cardiology, radiology, nuclear medicine, molecular biology, medical physics, and chemistry – and incorporates the use of all available imaging types, including echocardiography, cardiac CT, cardiac MRI, nuclear cardiology, PET/CT, CT/MRI, and ultrasound.

Our patients with heart and vascular conditions have access to top specialists throughout the fields of cardiovascular medicine, cardiac surgery, cardiac imaging, vascular surgery, and cardiac anesthesia. These physicians practice at the BWH Heart & Vascular Center, consistently ranked as one of the top 10 “Cardiology & Heart Surgery” providers in U.S. News and World Report's annual “America's Best Hospitals” survey.

Exercise Tolerance Test

Why Have an ETT?

This test is commonly used to detect coronary artery disease (blocked arteries in the heart) or to determine safe levels of exercise following a heart attack or heart surgery.

Types of Exercise Tolerance Tests

There are different types of exercise tolerance tests, including:

Exercise Stress Echocardiogram

A stress echocardiogram uses an exercise stress test and ultrasound imaging to look at structural images of the heart at rest and with exercise, including heart size, valve function, and heart wall motions (pumping action). It is used for patients who may have chest pain, shortness of breath (dyspnea), or abnormal resting electrocardiograms (ECGs).

Dobutamine Stress Echocardiogram

A dobutamine stress echocardiogram uses the medication dobutamine and an ultrasound of the heart. The dobutamine is used when a patient is not able to exercise adequately. Dobutamine mimics exercise in that it increases the heart rate and blood pressure. This test enables physicians to see what happens to the pumping action of the heart and valves at rest and during exertion. It is used for patients who have had chest pain, shortness of breath (dyspnea), abnormal ECGs, functional limitations of the aorta, a heart transplant, and/or are pre-operative.

Myocardial Perfusion Stress Test

A myocardial perfusion test uses an exercise stress test and radiotracers to assess the blood supply to the heart muscle. It is used for patients who may have chest pain, shortness of breath (dyspnea), or abnormal resting electrocardiograms (ECGs).

Maximal Oxygen Consumption Test

A maximal oxygen consumption test evaluates a patient's cardiopulmonary system by determining the amount of oxygen used by the body during exercise. Typically performed while a patient is on a stationary bike, this test is used to evaluate patients before or after a heart transplant or for individuals who may have shortness of breath (dyspnea), congestive heart failure, or cardiomyopathy.

Microvolt T-Wave Alternans Stress Test

A microvolt T-wave alternans stress test helps evaluate whether a patient is at risk of developing a life-threatening heart rhythm disorder and would benefit from having an internal cardoverter defibrillator (ICD). This is done by analyzing T-waves on an ECG.

What You Should Expect

The Heart & Vascular Center is located in the Shapiro Cardiovascular Center, across the street from BWH's main 75 Francis Street entrance. The Heart & Vascular Center brings together the full range of cardiovascular services in one location, fostering seamless and coordinated care for all patients.

Prior to an imaging procedure, patients check in at the Cardiovascular Imaging Center in the Shapiro Cardiovascular Center. During the procedure, family and friends can wait in the Shapiro Family Center.

Multidisciplinary Care

In addition to our cardiovascular imaging experts, patients also benefit from the teamwork of cardiologists, interventional cardiologists, cardiac surgeons, cardiac electrophysiologists, and anesthesiologists, all experts in cardiovascular disorders. These specialists work alongside nurses, physician assistants, physical therapists, dietitians, and social workers to achieve better outcomes for patients.

Resources

Learn about the Watkins Cardiovascular Clinic in the Shapiro Cardiovascular Center.

Visit the Kessler Health Education Library in the Bretholtz Center for Patients and Families to access computers and knowledgeable staff.

Access a complete directory of patient and family services.

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