EKGs and Exercise Stress Tests

When you need them—and when you don’t

EKGs and stress tests are tests that can help your doctor see how well your heart is working. An EKG, or electrocardiogram, measures your heart’s activity. In an exercise stress test, you have an EKG while you walk or jog on a treadmill.

You may need these tests if you have symptoms of heart disease, like chest pain. Or you may need them if you already have heart disease or
you have a high risk for heart disease. These tests can help your doctor evaluate how your heart is working and decide how to treat any problems.

But in other cases, you should think twice about having these tests. Here’s why:

Usually, you do not need these tests if you do not have any symptoms.

The tests are not useful for people who do not have symptoms of heart disease, like chest pain. Yet, many people with no symptoms have an EKG as part of their routine checkups.

For example, 1,200 adults between the ages of 40 and 60 were surveyed. These people had no history or symptoms of heart disease. Yet almost half had had an EKG in the last five years. And almost one out of ten had an exercise stress test.

There are better and less costly ways to prevent heart disease than EKGs and exercise stress tests.

These tests can lead to follow-up tests and treatments that you do not need.

EKGs and exercise stress tests will not harm you. But the results can be unclear. This can lead to other tests and treatments that do have risks.

For example, if the results of your EKG are unclear, your doctor may order a coronary angiography. This can expose you to as much radiation as 600 to 800 chest X-rays. Radiation has effects that can add up, so it is best to avoid it when you can.

EKGs and exercise stress tests can also lead to unnecessary treatments. You may be given drugs you do not need. Or, you may have a procedure called angioplasty to force open the arteries in your heart. This can help some people, but for many, lifestyle changes and medicine are just as good. Angioplasty causes a heart attack in one to two out of every 100 patients.

The tests can be a waste of money.

An EKG costs about $50, and an exercise stress test costs $175 or more. Why waste money on tests you do not need? And if they lead to more tests and treatments, it can cost thousands of dollars.

When are EKGs and exercise stress tests needed?

In some cases, it can be important to get these tests. You should probably have an EKG and an exercise stress test if you have symptoms of heart disease, such as chest pain, shortness of breath, an irregular heartbeat, or heavy heartbeats. You may also need the tests if you have a history of heart disease. And you may need these tests if you have diabetes or other risks. Your doctor may also want you to have an EKG before you begin an exercise program if you are at risk of heart disease.

This report is for you to use when talking with your health-care provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.

© 2016 Consumer Reports. Developed in cooperation with the American Academy of Family Physicians.