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Exercise EKG/ECG Testing for Children

What is exercise ECG testing?

An ECG (also called EKG) is one of the simplest and fastest procedures used to evaluate the heart. Electrodes (small, plastic patches) are placed at certain locations on your child's chest, arms, and legs. When the electrodes are connected to the ECG machine by lead wires, the electrical activity of your child's heart is measured, interpreted, and printed out for the doctor's information and 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.

An ECG tracing will be run at certain points during the test in order to compare the effects of increasing stress on the heart. On a treadmill, the incline and treadmill speed will be increased periodically in order to make your child exercise harder. If your child is riding a bicycle, he or she will pedal faster against increased resistance. Your child will exercise until reaching a target heart rate (determined by the doctor based on your child's age and physical status) or until your child is unable to continue due to fatigue, shortness of breath, chest pain, irregular heart rhythms, or other symptoms.

How is the exercise ECG test performed?

The procedure is performed in a doctor's office, clinic, hospital, or medical center. The equipment used includes an ECG machine, electrodes (small, plastic patches that stick on the skin), and lead wires which attach 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 only to the best of his or her ability. 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 within a few hours after the procedure, if not sooner.

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