Exercise Electrocardiogram Testing in Children

What is exercise electrocardiogram testing?

An electrocardiogram (also called an ECG or EKG) is a simple and fast procedure used to evaluate the heart rhythm and size. Electrodes (small, plastic patches) are placed on your child's chest, arms, and legs. When the electrodes are connected to the ECG machine by wires, the electrical activity of your child's heart is measured and printed out for the doctor's further interpretation.

An exercise ECG is performed to assess the heart's response to stress or exercise. The ECG is monitored while your child is exercising on a treadmill or stationary bike. The arm and leg electrodes are modified to allow for ease of exercise. While this procedure is seldom used for young children, it may be very useful in evaluating adolescents and young adults.

How is the exercise ECG test done?

The procedure is performed in a doctor's office or hospital. The equipment used includes an ECG machine, electrodes (small, plastic patches that stick on the skin), and wires which connect to the skin electrodes. A blood pressure cuff is also used to monitor your child's blood pressure response during exercise. A treadmill or stationary bicycle is used for exercise.

Your child will have initial, or "baseline," ECG and blood pressure readings done prior to exercising. He or she will walk on the treadmill or pedal the bicycle during the exercise portion of the procedure. The incline of the treadmill will be gradually increased, or the resistance of the bicycle will be gradually increased, in order to increase the intensity level of exercise. The ECG and blood pressure will be monitored during the exercise portion of the test. Symptoms are also carefully monitored during exercise. Your child will be asked to exercise to the best of his or her ability, but not to exhaustion. Following exercise, ECG and blood pressure readings are monitored for a short time, perhaps another 10 to 15 minutes or so.

The procedure will take approximately one hour, including check-in, preparation, and the actual procedure.

After the procedure, a hospital stay is not necessary, unless your child's doctor determines that your child's condition requires further observation or hospital admission.

Your child may feel a little tired or sore for a few hours after the procedure, particularly if he or she is not used to exercising. Otherwise, your child should feel normal soon after the procedure.

Depending on the results of the exercise ECG, additional tests or procedures may be scheduled to gather further diagnostic information.