Tredemølletest

Tredemølletest, or treadmill exercise test, is a non-invasive diagnostic procedure used to assess cardiovascular response to physical exertion and to detect myocardial ischemia. It is commonly performed on a motorized treadmill with increasing workload while monitoring electrocardiography, heart rate, blood pressure, and symptoms. In many centers, the test is combined with imaging or gas analysis to improve diagnostic accuracy.

The test is typically performed after baseline measurements. The patient walks on the treadmill at a low speed and incline, with workload increasing according to a chosen protocol, such as the Bruce protocol or ramp protocols. The test continues until the patient reaches maximal or submaximal exertion, or until objective signs of ischemia, arrhythmia, dizziness, severe shortness of breath, or fatigue occur. A target heart rate of about 85% of the age-predicted maximum is commonly sought, but the exact goal depends on clinical context and safety.

Measurements and interpretation include recording ECG changes, hemodynamic responses (blood pressure and heart rate), and subjective symptoms. Imaging data or metabolic measures may accompany the test to improve diagnostic accuracy. Ischemic indicators include ST-segment deviation or functionally significant arrhythmias and abnormal blood pressure responses. Baseline ECG abnormalities or concurrent medications can affect interpretation, so imaging-based stress tests are sometimes used when required.

Indications and safety considerations: The treadmill test is used to evaluate suspected coronary artery disease, assess functional capacity and prognosis, guide preoperative risk assessment, and monitor treatment effects. Limitations include false positives and negatives, the influence of medications such as beta-blockers, and interpretation challenges with abnormal baseline ECGs. It requires trained personnel and emergency equipment; adverse events are uncommon in appropriate settings.