What is an exercise tolerance test?

An exercise tolerance test (ETT) involves measuring the performance of your heart whilst you undergo exercise on a treadmill (running machine).

How is an ETT done?

You will be invited into a private consultation room. The person doing your ETT is called a cardiac physiologist.

You will be asked to undress to the waist and the cardiac physiologist will prepare your skin for the procedure by gently exfoliating a small area of skin on your chest and then cleaning this same area with an alcohol wipe. This is to ensure the electrodes (stickers), which will be used to record the electrical activity of your heart (known as an electrocardiogram or ECG), stay on.  

The electrodes are placed across the chest to record an ECG and a blood pressure cuff is placed around the upper arm. Readings are taken at regular intervals during the test. 

You will be asked to walk on a treadmill; the speed and gradient of the treadmill will be increased every three minutes automatically. The test will be stopped if you develop symptoms such as fatigue (tiredness), breathlessness, tired legs, chest pain or other symptoms. The cardiac physiologist will be at your side throughout the test and your blood pressure and ECG will continually be monitored.  

You will be encouraged to exercise as much as possible during the test. However, please tell the cardiac physiologist if you feel unwell or are unable to continue.

Your appointment will last 30-40 minutes.

Before your appointment

Stop taking your beta-blocker or calcium-channel blocker tablets for 48 hours before the test. If you are unsure or have any questions about stopping your medication, please contact your GP or the cardiology team on one of the telephone numbers below.

A list of the types of beta-blockers or calcium-channel blockers are below:

Beta blockers

  • Atenolol
  • Bisoprolol
  • Carvedilol
  • Acebutolol
  • Celiprolol
  • Esmolol
  • Labetalol
  • Metropolol
  • Nadolol
  • Nebivolol
  • Oxprenolol
  • Pindolol
  • Propanolol
  • Sotalol
  • Timolol

Calcium-channel blockers

  • Diltiazem
  • Verapamil

You should continue to take all other medications as normal.

Please do not eat a heavy meal for two hours prior to your appointment or drink alcohol for four hours before attending. Wear comfortable shoes and appropriate clothing for exercise and avoid using any body lotions. After your appointment Once the ETT is complete you can get dressed and you are free to leave. Your result will be sent to your referring doctor in time for your next appointment with them.

Risks and side-effects

The stickers used can cause a skin reaction. If you have an allergy to skin adhesive or plasters, please let us know. ETT is considered a very safe procedure, but rare complications such as heart attacks and serious abnormal heart rhythms may occur. If this were to occur, this would be treated by the team looking after you.