Signal
ST-Segment Depression >2mm During Exercise
Suggests
Significant ischaemia, possibly affecting more than one coronary artery.
Typical next step Within days
Cardiology referral; CT coronary angiogram or invasive angiography.
Cardiac Stress Test in Singapore
See how your heart responds to exertion with a doctor-supervised treadmill exercise ECG at our Partners Clinic. Same-day findings, Consultation included.
Live ECG MonitorBruce Protocol
142Heart Rate (BPM)Stage 3 · Target zone reached
- 10.2METs
- 3.4MPH
- 14%Incline
Estimated from $250
What is a Cardiac Stress Test?
Definition
A cardiac stress test measures how your heart performs under controlled physical exertion. By comparing readings at rest and under effort, a doctor can identify blocked arteries, rhythm disturbances, or reduced blood supply to the heart muscle that may not appear on a standard resting ECG.
How it works at Mediway Medical Centre
Mediway Medical Centre offers the treadmill exercise stress test (also called an exercise ECG). We have provided in-clinic ECG and treadmill stress testing since 2016. Reports are reviewed on the day by the supervising doctor, with a written report issued within 3 to 5 working days.
Specialist variants such as pharmacological stress, stress echocardiogram, and nuclear stress testing are referred to cardiology clinics or hospitals when clinically indicated.
When Should You Get a Cardiac Stress Test?
A cardiac stress test is usually considered when symptoms, risk factors, or clinical context call for a closer look at how your heart responds to exertion.
Symptom
Chest Discomfort
Persistent chest tightness, pressure, or unusual breathlessness when climbing stairs or exerting yourself.
Symptom
Palpitations or Fatigue
Unexplained fatigue on exertion, palpitations, or episodes of dizziness during activity.
Risk
CV Risk Factors
Diabetes, high blood pressure, high cholesterol, a smoking history, or a family history of early heart disease.
Pre-op
Pre-Op Clearance
Heart clearance before non-cardiac surgery, where general anaesthesia or post-op recovery places demand on the heart.
Clearance
Insurance / Employment
Exercise ECG needed for insurance underwriting, employment medicals, or aviation and maritime clearance.
Fitness
Return to Exercise
Resuming a structured exercise programme after a sedentary period, or returning to competitive sport after age 40.
Types of Cardiac Stress Tests in Singapore
Five cardiac investigations are commonly used in Singapore, each with its own strengths, radiation exposure, and cost profile. Mediway offers the treadmill exercise ECG; the other four are referred to partner cardiology clinics when clinically indicated.
| Offered at MediwayExercise ECG (Treadmill)From $250 | Stress Echocardiogram$600 to $900 (referred) | Nuclear Perfusion (MPI)$1,500 to $2,500 (referred) | Pharmacological$700 to $1,200 (referred) | CT Coronary Angiogram$1,362.50+ (referred) | |
|---|---|---|---|---|---|
| What it detects | Exercise-induced ECG changes, arrhythmias, and functional capacity | Wall motion abnormalities with ultrasound imaging | Regional blood flow and scar tissue in heart muscle | Ischaemic response when patient cannot exercise | Coronary artery narrowing and plaque (anatomy) |
| Radiation | None | None | Moderate | None | Moderate |
| Duration | 30 to 45 minutes | 45 to 60 minutes | 2 to 4 hours | 45 to 60 minutes | 15 to 30 minutes |
| Preferred when | First-line screen in mobile patients with cardiac risk factors | Baseline ECG abnormalities or need for imaging detail | Prior myocardial infarction; complex disease workup | Mobility limitation, joint or neurological conditions | Low-to-intermediate risk chest pain; younger patients |
| Referral required | No | Yes | Yes | Yes | Yes |
| Book this test |
Offered at Mediway
Exercise ECG (Treadmill)
From $250
- What it detects
- Exercise-induced ECG changes, arrhythmias, and functional capacity
- Radiation
- None
- Duration
- 30 to 45 minutes
- Preferred when
- First-line screen in mobile patients with cardiac risk factors
- Referral required
- No
Stress Echocardiogram
$600 to $900 (referred)
- What it detects
- Wall motion abnormalities with ultrasound imaging
- Radiation
- None
- Duration
- 45 to 60 minutes
- Preferred when
- Baseline ECG abnormalities or need for imaging detail
- Referral required
- Yes
Nuclear Perfusion (MPI)
$1,500 to $2,500 (referred)
- What it detects
- Regional blood flow and scar tissue in heart muscle
- Radiation
- Moderate
- Duration
- 2 to 4 hours
- Preferred when
- Prior myocardial infarction; complex disease workup
- Referral required
- Yes
Pharmacological
$700 to $1,200 (referred)
- What it detects
- Ischaemic response when patient cannot exercise
- Radiation
- None
- Duration
- 45 to 60 minutes
- Preferred when
- Mobility limitation, joint or neurological conditions
- Referral required
- Yes
CT Coronary Angiogram
$1,362.50+ (referred)
- What it detects
- Coronary artery narrowing and plaque (anatomy)
- Radiation
- Moderate
- Duration
- 15 to 30 minutes
- Preferred when
- Low-to-intermediate risk chest pain; younger patients
- Referral required
- Yes
Types of Cardiac Stress Tests in Singapore
Offered at Mediway
Exercise ECG (Treadmill)
From $250
- What it detects
- Exercise-induced ECG changes, arrhythmias, and functional capacity
- Radiation
- None
- Duration
- 30 to 45 minutes
- Preferred when
- First-line screen in mobile patients with cardiac risk factors
- Referral required
- No
Types of Cardiac Stress Tests in Singapore
Stress Echocardiogram
$600 to $900 (referred)
- What it detects
- Wall motion abnormalities with ultrasound imaging
- Radiation
- None
- Duration
- 45 to 60 minutes
- Preferred when
- Baseline ECG abnormalities or need for imaging detail
- Referral required
- Yes
Types of Cardiac Stress Tests in Singapore
Nuclear Perfusion (MPI)
$1,500 to $2,500 (referred)
- What it detects
- Regional blood flow and scar tissue in heart muscle
- Radiation
- Moderate
- Duration
- 2 to 4 hours
- Preferred when
- Prior myocardial infarction; complex disease workup
- Referral required
- Yes
Types of Cardiac Stress Tests in Singapore
Pharmacological
$700 to $1,200 (referred)
- What it detects
- Ischaemic response when patient cannot exercise
- Radiation
- None
- Duration
- 45 to 60 minutes
- Preferred when
- Mobility limitation, joint or neurological conditions
- Referral required
- Yes
Types of Cardiac Stress Tests in Singapore
CT Coronary Angiogram
$1,362.50+ (referred)
- What it detects
- Coronary artery narrowing and plaque (anatomy)
- Radiation
- Moderate
- Duration
- 15 to 30 minutes
- Preferred when
- Low-to-intermediate risk chest pain; younger patients
- Referral required
- Yes
What to Expect During the Test
A cardiac stress test at Mediway takes 30 to 45 minutes from arrival to recovery, with continuous ECG monitoring throughout.
-
Arrive & Prepare
01 Resting · ~70 bpm Change into comfortable clothing and trainers. Electrodes are placed on your chest for continuous ECG monitoring.
-
Baseline Readings
02 Baseline · ~75 bpm Resting ECG, blood pressure, and heart rate recorded before you start walking.
-
Exercise Phase
03 Target zone · ~150 bpm Bruce protocol: speed and incline increase every three minutes until target heart rate, symptoms, or you choose to stop.
-
Recovery & Review
04 Recovery · ~90 bpm ECG and BP tracked post-exertion. Doctor discusses preliminary findings; written report within 3 to 5 days.
How to Prepare for Your Cardiac Stress Test
Follow these four preparation steps so your readings are not influenced by food, caffeine, clothing, or medications.
- 01 Skip Heavy Meals 2 to 3 Hours Before Eat a light meal 2 to 3 hours ahead. Avoid heavy meals just before the test so blood flow is not diverted to digestion.
- 02 Skip Caffeine for 24 Hours Coffee, tea, cola, energy drinks, and chocolate can alter your heart rate response and mask findings.
- 03 Wear Comfortable Clothing & Trainers A loose T-shirt, tracksuit bottoms or shorts, and closed-toe trainers suitable for walking at speed.
- 04 Check Your Medications Some medications (particularly beta-blockers) may need to be paused before the test. Speak with your doctor before stopping anything.
Bruce Protocol Stages Explained
The Bruce protocol increases treadmill speed and incline every three minutes across seven stages. Each stage corresponds to a workload measured in METs (metabolic equivalents). Reaching Bruce Stage 4, roughly 13 METs, reflects good functional capacity and is associated with a lower probability of significant coronary artery disease in healthy adults aged 40 to 60.
- 11.7 mph · 10% incline4.6 METsLight warm-up pace
- 22.5 mph · 12% incline7.0 METsBrisk walking uphill
- 33.4 mph · 14% incline10.2 METsTypical healthy-adult target
- 44.2 mph · 16% incline12.9 METsGood functional capacity
- 55.0 mph · 18% incline15.0 METsTrained or athletic level
- 65.5 mph · 20% incline17.0 METsCompetitive-sport level
- 76.0 mph · 22% incline19.0 METsElite endurance level
- METs = metabolic equivalents (1 MET = resting oxygen use)
- Stopping early at Stage 1 or 2 without reaching target heart rate warrants follow-up
Understanding Your Cardiac Stress Test Results
Your report covers total exercise time, METs reached, Bruce stage, heart rate and blood pressure response, and any ECG changes. An abnormal result is not a diagnosis: it is a signal to arrange further assessment. Four common abnormal patterns, and their typical next steps, are shown below.
Signal
Chest Pain or Breathlessness at Low Workload
Suggests
Symptom reproduction suggestive of exertional angina, even without striking ECG changes.
Typical next step Within 1–2 weeks
Stress echocardiogram or CT coronary angiogram to clarify the cause.
Signal
Drop in Blood Pressure During Exertion
Suggests
Poor cardiac output response, which can indicate significant coronary disease or ventricular dysfunction.
Typical next step Within days
Prompt cardiology review; echocardiogram and further imaging.
Signal
Functional Capacity Below 7 METs
Suggests
Reduced exercise tolerance, which is an independent predictor of cardiovascular risk.
Typical next step At next visit
Risk-factor optimisation; stress imaging or cardiology review depending on symptoms.
What a normal result means
A normal stress test lowers the likelihood of significant coronary artery disease but does not rule it out completely. Your doctor will explain your full report and arrange any follow-up investigations (stress echocardiogram, CT coronary angiogram, or cardiology referral) as clinically appropriate.
Cardiac Stress Test Pricing at Mediway
At Mediway Medical Centre, a treadmill exercise ECG costs from S$250 and takes 30 to 45 minutes including preparation and recovery. All prices are estimates, inclusive of GST, and may vary depending on individual clinical needs.
Signature test
Primary cardiac stress test
Treadmill Stress Test
Bruce protocol exercise ECG with continuous monitoring, doctor supervision, and a signed report. The cardiac stress test this page is about.
$250GST inclusive
- Bruce protocol exercise ECG
- GP consultation & briefing
- Continuous BP & HR monitoring
- Report within 3 to 5 working days
Other cardiac tests at Mediway
Baseline
Resting ECG
from $30
- 12-lead resting ECG
- Doctor interpretation
Ambulatory
24-Hour Holter Monitor
$500
- Continuous 24-hour ECG recording
- Arrhythmia analysis
- Report with rhythm summary
Same-day
Instant-Check ECG
$400
- Same-day recording and analysis
- Priority doctor review
- Report issued on the same visit
Resting ECG: from $30 as a health-screening add-on. All prices are estimates inclusive of GST. Actual pricing may vary depending on individual clinical needs. Please contact us for the latest pricing.
Safety and Risks
A treadmill exercise stress test is considered safe for most people when performed by a trained team with emergency equipment on hand. Serious complications are uncommon.
Medical contraindications
The test is generally not recommended if you have
- Unstable angina or recent heart attackWithin the past few days; the heart needs stabilisation before any stress testing.Acute
- Severe structural heart diseaseSevere aortic stenosis or other major structural issues that restrict safe exertion.Structural
- Uncontrolled heart failure or arrhythmiaSymptomatic heart failure or rhythm disturbances that are not yet stable on treatment.On treatment
- Severely high blood pressure on the dayIf resting BP is very high at check-in, the doctor may reschedule the test.Day-of
- Acute infection or other acute illnessFever, active infection, or any acute illness that would make exercise unsafe.Acute
Alternative investigations
Where any of the above apply, your doctor may suggest a pharmacological stress test, stress echocardiogram, or direct cardiologist referral depending on your clinical picture.
Frequently Asked Questions
Answers to the most common questions about cardiac stress testing at Mediway.
01How long does a cardiac stress test take?
A cardiac stress test at Mediway takes 30 to 45 minutes from arrival to recovery. This includes placement of ECG electrodes, baseline readings, the treadmill exercise phase, and continued monitoring in recovery until your heart rate and blood pressure return towards baseline. Allow a little extra time for the initial doctor briefing.
02Is a cardiac stress test painful?
The test itself is not painful. It involves walking on a treadmill at gradually increasing speed and incline, similar to a brisk uphill walk that becomes more demanding in stages. You may feel normal exercise sensations: warmth, faster breathing, and tired legs. ECG electrodes are self-adhesive pads; some chest hair may need to be trimmed for a clean signal.
03Do I need to fast before the test?
Strict fasting is not required. You should avoid food for two to three hours and caffeine for twenty-four hours before a treadmill stress test. Eat a light meal 2 to 3 hours ahead so you are neither hungry nor full during the test, and stay well hydrated with water.
04Can I take my heart medications on the day?
Some medications can affect test results and may need to be paused. Beta-blockers in particular can blunt the heart rate response and make it harder to reach the target rate. Do not stop any medication on your own. Speak with your doctor before the test so specific instructions can be given based on the medicines you are taking.
05What does Bruce Stage 4 mean?
Bruce Stage 4 is the fourth three-minute interval of the treadmill stress test, at 4.2 mph and 16 per cent incline, equivalent to roughly 13 METs. Reaching Stage 4 reflects good functional capacity for most adults aged 40 to 60 and is associated with a lower probability of significant coronary artery disease. Your doctor will interpret the stage reached alongside your heart rate response, blood pressure, symptoms, and ECG tracings.
06Can I walk instead of run?
Yes. The Bruce protocol is designed as a walking test: Stage 1 starts at 1.7 mph with a gentle incline, and later stages become a fast uphill walk or light jog. You walk at the treadmill’s set pace; the goal is to reach a target heart rate or sustained workload, not to sprint. You can stop at any time if you feel unsteady or unwell.
07What happens if my result is abnormal?
An abnormal stress test is not a diagnosis. It means the ECG, heart rate, or blood pressure response during exertion suggests the heart muscle may not be receiving adequate blood flow, or that a rhythm disturbance is present. The usual next step is a stress echocardiogram, CT coronary angiogram, or referral to a cardiologist for further assessment. At Mediway, our doctor will discuss findings with you on the day and arrange onward investigations as clinically indicated.
08Do I need a referral to book a cardiac stress test at Mediway?
No referral is required. You can book a cardiac stress test directly with Mediway Medical Centre. A GP consultation is included so the doctor can review your symptoms, risk factors, and medications before the test, and discuss findings with you afterwards. If your situation calls for a stress echocardiogram or nuclear study, we will arrange referral to a partner cardiology clinic.
Still have a question?
Our team answers cardiac stress test queries quickly over WhatsApp or phone during clinic hours.
Book Your Cardiac Stress Test
Located at The Riverwalk, a 2-minute walk from Clarke Quay MRT (Exit E). Walk-in or booked appointments welcome.
- 20 Upper Circular Rd, #B1-26/29 The Riverwalk, Singapore 058416
- Clarke Quay MRT (NE5), Exit E · 2-minute walk
- Hours: Mon to Fri 7:30am to 6pm · Sat 7:30am to 1pm
Directions
Located in central Singapore, just a 2-minute walk from Clarke Quay MRT.
Clarke Quay Station (NE5)
Exit E. 2-minute walk along the river towards The Riverwalk building. We are at #B1-26/29.
Opp Clarke Quay Station (B04239)
Bus No: 2, 12, 33, 54, 147, 190, 12E, TS3, 147A
Clarke Quay Station Exit E (B04222)
Bus No: NS1, NS2, 2, 2A, 12, 12E, 33, 51, 54, 61, 63, 80, 124, 145, 147, 166, 174, 174E, 190, 197, 851, 851E, 961, 961M
Opp High Street Centre (B04251)
Bus No: 32, 195, 195A
Boat Quay (B05029)
Bus No: NS1, NS2, 51, 61, 63, 63A, 80, 124, 145, 166, 174, 174E, 197, 851, 851E, 961, 961M
The Riverwalk Carpark
Mon–Fri before 5/6pm: $2.00 for 1st hr, $1.00 for next subsequent 30min from 7am to 5pm
Mon–Fri after 5/6pm: $3.21/entry from 5pm to 7am the following day
Sat: $2.00 for 1st hr, $1.00 for next subsequent 30min from 7am to 5pm, $3.21/entry from 5pm to 7am the following day
Sun/PH: $3.21/entry from 7am to 7am the following day
References
- Singapore Heart Foundation. Heart Health Guides & Risk Factors. Available at myheart.org.sg/health/risk-factors.
- Ministry of Health, Singapore (HealthierSG Care Protocol). Stable Ischaemic Heart Disease / Chronic Coronary Syndrome. Available at primarycarepages.sg/ischaemic-heart-disease.
- Gulati M, Levy PD, Mukherjee D, et al. 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain. Circulation, 2021. Available at pubmed.ncbi.nlm.nih.gov/34709879.