You try to climb a flight of stairs, but you have to stop halfway. Your chest feels tight, and you are gasping for air. Is it just because you are out of shape, or is your heart trying to tell you something? Heart disease is the leading cause of death for both men and women. However, many heart problems do not show up when you are just sitting on the doctor’s exam table. They only appear when your heart has to work hard.
This is where a “stress test” comes in. Also known as an exercise stress test or a treadmill test, this procedure monitors your heart while you walk or run. It helps doctors see how your heart handles pressure. Many people wonder if they need one. You might feel fine most of the time, but specific warning signs suggest your heart needs a closer look.
Why early detection matters
Proactive heart health is about more than just avoiding emergencies; it is about reclaiming control over your long-term well-being. Early detection, particularly through diagnostic tools like a cardiac stress test, serves as a critical window into your cardiovascular health. These tests are designed to monitor how your heart performs under physical exertion, allowing healthcare professionals to identify arterial blockages or irregularities long before they manifest as a life-threatening event.
According to the American Heart Association, identifying these issues in their infancy provides a precious opportunity to pivot toward less invasive interventions. Ultimately, taking the initiative to screen for heart health doesn’t just save lives – it preserves the quality of life. By addressing symptoms early, you ensure that you can remain active, healthy and present for the moments that matter most. Here are signs you should consider asking your doctor about a stress test.
1. You have chest pain during exercise
This is the number one reason healthcare professionals order this test. If you feel pressure, squeezing or pain in the center of your chest when you walk fast or lift heavy things, it is a red flag. This type of pain is called “angina.” It happens because your heart muscle is not getting enough oxygen-rich blood when it needs it most. When you rest, the pain usually goes away because the heart slows down and doesn’t need as much blood.
The Mayo Clinic explains that chest pain that comes and goes with activity is a classic sign of coronary artery disease, which a stress test is designed to detect.
2. You get short of breath too easily
It is perfectly normal to feel winded after sprinting for a bus or finishing a high-intensity workout. However, there is a significant physiological difference between healthy exertion and exercise intolerance. When simple activities (like walking to the mailbox or climbing a single flight of stairs) leave you gasping for air, your body is sending a loud, clear signal that something is wrong.
This sudden decline in physical capacity often points to a mismatch between your body’s oxygen demand and your heart’s ability to supply it. If your heart is struggling with blocked arteries or weakened muscle function (heart failure), it cannot pump oxygenated blood efficiently to your muscles. According to Johns Hopkins Medicine, this unexplained shortness of breath, known clinically as dyspnea, is one of the most reliable “check engine” lights for cardiovascular distress.
3. Your heart flutters or skips beats
It is normal for your heart to beat faster when you run. However, it is not normal for it to feel like it is flopping around in your chest like a fish. This sensation is called heart palpitations. You might feel like your heart is skipping a beat, racing out of control or thumping irregularly.
If this occurs while you are active, it may indicate an exercise-induced arrhythmia (irregular heartbeat). A stress test can provoke this rhythm while you are hooked up to an EKG, allowing the doctor to see exactly what is happening electrically.
4. You get dizzy when you move
Feeling lightheaded while you’re pushing your body isn’t just an inconvenience – it’s a neurological SOS. While we might expect to feel tired or breathless during a workout, feeling as though the world is spinning or that you might lose consciousness (syncope) during exertion is a major red flag that should never be ignored.
Under normal circumstances, your heart rate and blood pressure should rise in tandem with your activity level to ensure your brain and muscles stay fueled. However, if your blood pressure unexpectedly drops or your heart rate fails to keep pace, your brain is the first organ to “starve” for oxygen. According to the Cleveland Clinic, this sensation of dizziness during movement often points to mechanical issues within the heart.
5. You are about to start a new workout program
“Sometimes, you need a stress test even if you do not have symptoms, explains Dr. Justus Rabach, MD. “If you have lived a sedentary life (sitting on the couch) for years and decide to start training for a 5K, your doctor might want to check your engine first.”
This is especially true if you are older than 40 or have risk factors like smoking, diabetes or high cholesterol. The test ensures your heart is strong enough to handle the sudden increase in physical activity without putting you in danger.
What are the warning signs of burnout?
Sometimes, “stress” is not about clogged arteries. It is about mental exhaustion. While a cardiac stress test looks for physical blockages, it is essential not to ignore signs of mental burnout, which can hurt your heart too.
Chronic fatigue shows up as a deep, constant exhaustion that sleep does not relieve. Detachment develops when you begin to feel emotionally numb or cynical toward your work and family, creating distance from people and responsibilities that once mattered. Physical illness often follows, as prolonged stress weakens the immune system, making you more likely to get sick frequently and recover more slowly.
According to the World Health Organization, burnout is an occupational phenomenon characterized by energy depletion. While a treadmill test will not diagnose this, high mental stress can raise your blood pressure and heart rate, putting you at risk for the physical heart problems mentioned above.
What causes you to fail a stress test?
Failing a stress test doesn’t mean you are “bad” at exercise. It simply means the test found a problem. There are a few specific things that doctors consider a “fail” or an “abnormal result.”
ST Segment Changes: This is a wavy line on the EKG monitor. If this line moves up or down by a certain amount, it is strong evidence that part of your heart is starving for blood (ischemia).
Arrhythmias: If exercise triggers a dangerous heart rhythm, the doctor will stop the test immediately.
Blood Pressure Issues: Your blood pressure should go up when you run. If it drops, it suggests your heart is weak.
Severe Symptoms: If you must stop the test early due to chest pain or severe dizziness, it is considered an abnormal result.
As Harvard Health Publishing explains, an abnormal result typically leads to additional testing, such as an angiogram, to identify the exact blockage.
Do you get your stress test results immediately?
The doctor or technician supervising the test can often provide a preliminary assessment right away. They might say, “Your EKG looked normal,” or “We saw some changes, so we need to look closer.”
However, the official results take time to be released. A cardiologist needs to review every minute of the EKG recording. If you had a “Nuclear Stress Test” (which uses dye and a camera), it would take longer. A radiologist must analyze images of your heart’s blood flow. You can typically expect the complete, final report within two to three days.
When to see a doctor
You should not wait for an annual check-up if you are worried about your heart. Make an appointment specifically to discuss a stress test if you have a family history of heart attacks before age 55.
See a doctor if you have high cholesterol, high blood pressure or diabetes, as these increase your risk of “silent” heart disease. If you ever experience sudden, crushing chest pain that spreads to your jaw or left arm, do not call a doctor for a stress test. Call 911 immediately. That is a medical emergency.
“Stress and sleepless nights are closely linked,” says Johns Hopkins sleep expert Luis F. Buenaver, Ph.D., C.B.S.M. “If you’re in pain, tend to worry or are coping with a difficult situation in your life, you may have more stress hormones than usual circulating in your body. A poor night’s sleep adds even more. And those hormones may never be fully broken down. It’s like running an engine in fifth gear all the time.”
Bottom line
A stress test is a vital tool for revealing heart problems that may be hidden at rest. If you experience chest pain, unusual shortness of breath or irregular heartbeats during exercise, you likely need this test. Detecting these issues early allows doctors to treat blocked arteries before they cause a heart attack, ensuring you can stay active and healthy for years to come.
Frequently Asked Questions
How fast does a treadmill go during a stress test?
The test usually follows the “Bruce Protocol,” in which speed and incline increase every three minutes. It starts slowly at 1.7 mph and can reach up to 5 or 6 mph on a steep hill, though most people stop before that.
How long does the average person last on a treadmill during a stress test?
The average adult runs for about seven to 10 minutes on a treadmill, aiming to reach a target heart rate rather than run a marathon.
What is a normal blood pressure for a stress test?
It is normal for your systolic blood pressure (the top number) to rise anywhere from 160 to 200 mm Hg during peak exercise, but it should drop back down quickly once you stop moving.
Citations
American Heart Association. Exercise stress test. www.heart.org. Published 2015. https://www.heart.org/en/health-topics/heart-attack/diagnosing-a-heart-attack/exercise-stress-test
Mayo Clinic. Stress test – Mayo Clinic. Mayoclinic.org. Published 2018. https://www.mayoclinic.org/tests-procedures/stress-test/about/pac-20385234
Johns Hopkins Medicine. Exercise Stress Test. Hopkinsmedicine.org. Published 2025. https://www.hopkinsmedicine.org/all-childrens-hospital/services/heart-institute/heart-institute-programs-and-services/pediatric-cardiology-services/exercise-stress-test
Cleveland Clinic. Exercise Stress Test. Cleveland Clinic. Published January 17, 2022. https://my.clevelandclinic.org/health/diagnostics/16984-exercise-stress-test
World Health Organization. Burn-out an “occupational phenomenon”: International classification of diseases. World Health Organization. Published May 28, 2019. https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases
Harvard Health Publishing. Cardiac exercise stress testing: What it can and cannot tell you – Harvard Health. Harvard Health. Published March 18, 2013. Accessed February 6, 2026. https://www.health.harvard.edu/heart-health/cardiac-exercise-stress-testing-what-it-can-and-cannot-tell-you
Johns Hopkins Medicine. Sleepless Nights? Try Stress Relief Techniques. www.hopkinsmedicine.org. Published 2024. https://www.hopkinsmedicine.org/health/wellness-and-prevention/sleepless-nights-try-stress-relief-techniques