An ECG treadmill test, or exercise stress test, records the heart’s electrical activity while you walk or run on a treadmill as intensity increases. Electrodes monitor heart rate, rhythm, and electrical changes to detect reduced blood flow (ischemia), exercise‑induced arrhythmias, and functional capacity. Blood pressure and symptoms are tracked; the test helps diagnose coronary artery disease and guide treatment or further testing.

During a treadmill (exercise) ECG, heart rate increases with sinus tachycardia; PR and QT intervals may shorten. Ischemic findings include horizontal or downsloping ST-segment depression (suggesting ischemia) or ST elevation in acute injury. T-wave inversion can appear. Exercise may also provoke arrhythmias (PVCs, SVT) or new bundle-branch block; interpretation depends on magnitude, morphology, lead distribution and symptoms.

Treadmill ECG (exercise ECG) is useful but not perfectly accurate. It helps detect coronary artery disease and provides prognostic information, especially in people with intermediate pretest probability and a normal resting ECG. Sensitivity and specificity are moderate; false positives (more common in women or with baseline ECG abnormalities) and false negatives occur. Accuracy improves when combined with imaging or clinical assessment.

A treadmill (exercise) ECG can show signs suggestive of coronary artery blockage — abnormal ECG changes, chest pain, blood-pressure response or reduced exercise capacity — but it isn’t definitive. Sensitivity and specificity are limited, so a normal test doesn’t fully exclude disease and an abnormal result usually needs follow-up with stress imaging, CT coronary angiography or invasive angiography to confirm blockages.

A positive treadmill (exercise stress) test suggests reduced blood flow to the heart and possible coronary artery disease but isn’t definitive. Next steps include cardiology referral for further testing—stress imaging (stress echocardiogram or nuclear test), coronary CT or invasive coronary angiography—to confirm diagnosis. Treatment may involve medications (antiplatelets, statins, beta‑blockers), lifestyle changes, and, if needed, coronary revascularization (angioplasty or bypass).

Costs vary by country and setting. A basic treadmill (exercise) ECG typically costs about ₹500–2,500 in India, £80–£300 privately in the UK (free through public health systems), and roughly $200–$1,200 or more in the US. Additional tests (stress echo, nuclear imaging, specialist consultations) increase the price. Exact fees depend on the facility and included reporting.