The patient undergoes a standardized exercise protocol eg Bruce. This involves the patient walking on a treadmill and the intensity of the exercise is modified by adjusting the pace and slope of the treadmill. The patient is continually monitored using a 12-lead ECG. Also the patient's blood pressure is monitored.
The test is usually carried out with the assistance of cardiographic technicians, and they are generally very experienced at interpretation of ECG changes. The principle changes that are being monitored for are those of ischaemia, ie ST depression. The ECG must be monitored for ST depression with a 'flattening out' of the ST segment. An ST depression with an upward sloping ST segment is associated with a very low incidence of ischaemic heart disease and is an unreliable indicator of ischaemic heart disease.
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