What is an exercise ECG (treadmill test)? How it differs from a resting ECG and a coronary CT scan, and public or private in Hong Kong

What is an exercise ECG and what does it check?

A treadmill exercise ECG is a non-invasive test: as running speed and platform incline increase, the heart's workload and oxygen demand rise, to see whether the heart muscle lacks blood supply and whether the heart rhythm becomes irregular or changes dangerously; it can also assess the fitness of patients with heart disease (St. Paul's Hospital, accessed October 2026).

For patients suspected of heart disease whose heart muscle shows no lack of oxygen at rest, a cardiologist may recommend an exercise ECG, watching heart-lung function, blood pressure and ECG changes in real time on a treadmill to assess for ischaemic heart disease (Hong Kong Adventist Hospital – Stubbs Road, accessed October 2026).

How does an exercise ECG differ from a resting ECG and a coronary CT scan?

The table is arranged from the Adventist Hospital's published description; for resting and 24-hour ECGs see ECG test, and for public and private routes to a CT scan see MRI and CT: public or private. Which test suits an individual patient is decided by the doctor.

Where can I have an exercise ECG? Public or private?

To book a new case at a public hospital specialist outpatient clinic, a referral letter issued by a locally registered doctor within the last three months is required (Hospital Authority, January 2018); for public cardiology waiting arrangements and fees see public cardiology waiting time vs private.

For private hospital and medical centre fees for exercise ECGs and coronary CT scans see heart test fees; the CUHK Medical Centre Cardiology Centre has designated fees for patients holding a valid Hospital Authority referral letter, who must show the original letter (CUHK Medical Centre, accessed October 2026).

How do I prepare for an exercise ECG?

The Adventist Hospital's precautions cover ECG tests in general and do not deal specifically with the exercise ECG; for clothing, eating and medicines before an exercise ECG, follow the instructions of the hospital where you book.

If you take regular medicines, ask when booking how to handle them before the test.

Chest tightness during exercise: who decides whether I need an exercise ECG?

The most common symptoms of coronary heart disease include angina, usually described as chest pain, tightness or a feeling of pressure that may spread to the arms, neck, jaw, shoulders and back, brought on by physical effort such as climbing stairs and easing after a few minutes' rest; anyone who suspects coronary heart disease should see a doctor at once, and the doctor reviews the medical history and arranges tests as needed, which may include an ECG, imaging and cardiac catheterisation (Centre for Health Protection, accessed October 2026).

Whether to have an exercise ECG or another heart test is decided by the doctor according to the condition; individual cases are decided by the treating doctor. Signs of a heart attack include severe chest pain that may spread to the neck, arm or jaw, heavy sweating, shortness of breath, nausea, dizziness or even loss of consciousness, and the Department of Health Elderly Health Service advises seeing a doctor at once or going to an Accident and Emergency department if these signs appear (accessed October 2026); for emergencies see urgent help.

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