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Ergometry – Exercise Stress Test Explained

Ergometry is a medical stress test used to assess the function of the heart and circulatory system during physical exertion. It helps diagnose heart conditions and evaluate overall physical fitness.

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Things worth knowing about "Ergometry"

Ergometry is a medical stress test used to assess the function of the heart and circulatory system during physical exertion. It helps diagnose heart conditions and evaluate overall physical fitness.

What Is Ergometry?

Ergometry is a diagnostic procedure in which the function of the heart and cardiovascular system is assessed under gradually increasing physical stress. The term derives from the Greek word ergon, meaning work. The test is also commonly referred to as an exercise ECG or exercise stress test, as an electrocardiogram (ECG) is continuously recorded throughout the physical activity. Ergometry is one of the most widely used non-invasive diagnostic methods in cardiology and sports medicine.

Indications

Ergometry is used in various medical settings. The most common indications include:

Evaluation of chest pain (angina pectoris) and suspected coronary artery disease (CAD)
Assessment of cardiac function following a heart attack
Monitoring the effectiveness of treatment in patients with known heart conditions
Detection of exercise-induced arrhythmias
Determination of physical fitness and maximal oxygen uptake (VO₂max)
Sports medicine performance diagnostics and training planning
Preoperative risk stratification

How Ergometry Is Performed

The test is typically performed on a stationary bicycle ergometer or a treadmill. The workload is increased in defined stages (usually every 2 to 3 minutes) until a target heart rate is reached, symptoms appear, or a predefined stopping criterion is met.

Preparation

Before the test, ECG electrodes and a blood pressure cuff are applied. The patient should arrive fasting or at least 2 hours after a light meal. Certain medications, such as beta-blockers, may affect the test results and should be paused in consultation with the treating physician if appropriate.

Procedure

The test begins with a resting ECG as a baseline recording. Physical exercise then starts and is gradually increased in intensity. Throughout the entire examination, ECG readings, heart rate, and blood pressure are continuously monitored and documented. After the exercise phase, a recovery period follows during which all parameters continue to be observed.

Interpretation and Results

The key parameters evaluated during ergometry include:

ECG changes: Typical signs of cardiac ischemia (reduced blood flow to the heart) include ST-segment depression or elevation under exercise conditions.
Heart rate response: The rise and recovery of heart rate provide information about cardiac fitness.
Blood pressure response: An excessive rise in blood pressure (hypertensive response) or a drop under exertion may indicate underlying conditions.
Exercise capacity: The maximum workload achieved (in watts) is an important indicator of physical and cardiac performance.
Symptoms: Any symptoms experienced during the test, such as chest pain, dizziness, or severe shortness of breath, are documented.

Stopping Criteria

The test is immediately terminated if any of the following occur:

Severe chest pain or angina pectoris
Significant ECG changes (e.g., pronounced ST-segment depression)
Dangerous cardiac arrhythmias
A notable drop in blood pressure during exercise
Severe physical exhaustion or significant shortness of breath
Patient request to stop

Risks and Contraindications

Ergometry is generally a safe procedure. Serious complications such as a heart attack or life-threatening arrhythmias are very rare (approximately 1 in 10,000 tests). The test should not be performed in cases of:

Acute myocardial infarction or unstable angina
Severe heart failure
Uncontrolled hypertension
Severe cardiac arrhythmias
Acute inflammatory heart disease (myocarditis, pericarditis)
Severe symptomatic aortic stenosis

References

Gibbons RJ et al. - ACC/AHA 2002 Guideline Update for Exercise Testing. Journal of the American College of Cardiology, 2002.
Fletcher GF et al. - Exercise Standards for Testing and Training: A Scientific Statement from the American Heart Association. Circulation, 2013; 128(8): 873-934.
Löllgen H, Leyk D - Exercise testing in sports medicine. Deutsches Ärzteblatt International, 2018; 115(24): 409-416.

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