TMT is the most widely used test in the diagnosis of ischemic heart disease. It involves recording the 12-lead ECG before, during, and after exercise on a treadmill.
The test consists of a standardized gradual incremental increase in external workload while the patient's ECG, symptoms, and arm blood pressure are continuously being monitored. The test is discontinued upon evidence of chest discomfort, severe shortness of breath, dizziness, fatigue, ST-segment depression of greater than 0.2 mV (2 mm), a fall in systolic blood pressure exceeding 10 mmHg, or the development of a ventricular tachyarrhythmia.
This test helps to discover any relation between exercise and chest discomfort and the typical ECG signs of myocardial ischemia.
The physician should be present throughout the exercise test, and it is important to measure total duration of exercise, the times of the onset of ischemic ST-segment change and chest discomfort, the depth of the ST-segment depression and the time needed for recovery of these ECG changes are also important.
Because the risks of exercise testing are small but real, equipment for resuscitation should be available.