At your appointment, you will be asked to lie flat on an examination couch for 10 minutes or until a baseline of your BP and HR are established. You will then stand for a maximum of 5 minutes. You will be asked to rest again prior to performing the exercise. For the exercise, you will be asked to cycle on a bike whilst lying flat. A picture can be seen below that demonstrates the test. You will need to cycle at a continuous set speed, with the resistance of the bike gradually increased over a set period of time. You will need to perform the exercise until you feel you have achieved a good cardiovascular workout. You will be encouraged to work to your maximum effort during the exercise. Following the exercise, you will enter a rest period before standing again for 5 minutes.
How do I prepare for the test?
Please do not eat for 4 hours prior to testing. You may drink water only in the lead up to the test. Please do not drink alcohol & do not carry out heavy exercise 12 hours prior to your appointment.
Please wear loose fitting clothing on the day of your appointment. We recommend a loose fitting T-shirt and loose fitting trousers or shorts.
Please bring a pair of socks for the exercise test. You do not need to bring trainers for the exercise test as they will not fit into the pedals of the bike.
How will I feel during the test?
The test also examines the effects of orthostatic stress on BP and HR. You will be asked to stand for a maximum of 5 minutes prior to and after exercise. During the stand, non-invasive methods are used to measure the BP and HR. You may experience symptoms of Orthostatic Intolerance (OI), pre-syncope or syncope during the stand. Typical symptoms include, but are not limited to; dizziness, palpitations, nausea, blurred vision and / or episodes of syncope. If you are no longer able to tolerate standing or you feel imminent syncope, please sit or lie down on the tilt bed immediately. Full recovery of symptoms is usually instantaneous upon returning to a horizontal position.
You are expected to remain aware of your own condition throughout testing, and should any unusual symptoms occur, you must inform the test administrator of the symptoms. Typical symptoms include, but are not limited to; chest discomfort, dizziness, palpitations, nausea, blurred vision and / or episodes of syncope.
What are the risks?
The exercise test is generally safe, and complications are rare. But, as with any medical procedure, it does carry some risks. All patients will be asked to fill out a pre-assessment questionnaire, which will further assess an individual’s risk factors. If any known risk factors are highlighted, the test will be modified to minimise the risk.
Occasional undesirable changes may occur during the exercise test. These include abnormal blood pressure, prolonged tachycardia & loss of consciousness. Every effort will be made to minimise problems by observations throughout testing and early termination of the test, if required.
Who should not have a modified exercise test?
If you have any of the following conditions you should not undergo the modified exercise test: high-risk unstable angina, decompensate or inadequately controlled congestive heart failure, uncontrolled hypertension, uncontrolled cardiac arrhythmias, acute myocardial infarction (in last 6 months) suspected, acute coronary syndrome, 3rd-degree heart block, uncontrolled diabetes mellitus and / or severe stenosis.
What happens if I have questions?
If you have any questions or concerns, please ask the clinical autonomic scientist before signing the consent form for the procedure. If you are not happy to proceed with the test, please inform a member of the testing team. Even after signing the consent form, you may withdraw your consent at any time during the test.
When will I get my results from the test?
We are unable to provide results of the test on the day of your appointment. All results will be sent to Professor Mathias. You will need to arrange a follow up appointment with Professor Mathias to discuss the results of the test(s). Please email firstname.lastname@example.org to arrange the appointment.