A/Prof Saurabh Kumar

Cardiologist & Electrophysiologist
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Exercise Stress Testing

Evaluating heart function when it matters most — under physical stress

Some heart conditions only become apparent when the cardiovascular system is under pressure. Exercise stress testing is a widely used diagnostic tool that evaluates how your heart performs during physical exertion. It helps identify conditions such as coronary artery disease, rhythm disturbances, and exercise intolerance that may not be evident at rest.

At his Sydney-based practice, A/Prof Saurabh Kumar offers a comprehensive range of stress testing services tailored to each patient’s clinical background and activity level. As a Cardiologist and Interventional Electrophysiologist, he combines functional assessments with advanced imaging and rhythm evaluation to deliver accurate, personalised care.

When Is Exercise Stress Testing Recommended?

Exercise testing is commonly performed to investigate symptoms, assess cardiovascular fitness, or guide treatment decisions. Common indications include:

Stress testing is frequently used to assess whether chest pain is caused by restricted blood flow to the heart (ischaemia). It is particularly helpful in patients with stable symptoms and intermediate risk factors.
For individuals who feel unusually tired or short of breath with exertion, exercise testing can help identify whether the cause is cardiac, pulmonary, or deconditioning.
Some rhythm abnormalities only occur during physical activity. Exercise stress testing allows real-time monitoring of your heart rhythm while symptoms are provoked in a controlled environment.
Stress testing can assess how well current treatments are working, whether symptoms have progressed, and whether further intervention is needed.
In some cases, patients require cardiac clearance before undergoing surgery or engaging in high-level sport. Exercise testing helps determine whether the heart can safely meet increased physiological demands.

Types of Exercise Stress Testing Offered

A/Prof Kumar offers multiple forms of exercise stress testing depending on the patient’s symptoms, cardiovascular risk profile, and underlying heart function.

This is the most common type of stress test. You will walk on a treadmill at gradually increasing speeds and inclines while your heart rate, rhythm, and blood pressure are monitored. The test continues until you reach a target heart rate, experience symptoms, or develop changes in your ECG.

It is a valuable tool for:

  • Identifying ischaemia in patients with chest pain
  • Diagnosing exertional arrhythmias
  • Measuring fitness and exercise tolerance
  • Monitoring the effectiveness of treatment for known coronary artery disease

This combines exercise testing with cardiac ultrasound. Images of the heart are taken at rest and immediately after exercise to assess how well the heart muscle contracts under stress. This test offers increased accuracy in detecting ischaemia compared to ECG stress testing alone.

It is particularly useful when:

  • The baseline ECG is abnormal
  • A more sensitive assessment of blood flow or wall motion is needed
  • A non-invasive alternative to coronary angiography is preferred
Stress testing also allows for an objective measurement of how much physical activity a patient can tolerate before symptoms arise. This can guide fitness planning, help assess disability, or determine the impact of cardiac rehabilitation and other treatments.

What the Test Can Reveal

Stress testing can uncover a range of clinically significant findings that inform both diagnosis and management. These include:
When narrowed coronary arteries are unable to deliver adequate blood flow during exercise, ECG changes and symptoms such as chest pain or shortness of breath may occur. These findings suggest underlying coronary artery disease and may lead to further testing, including CT coronary angiography or angioplasty.

Some patients develop abnormal heart rhythms only during exercise or in the immediate recovery phase. These can range from premature beats to more serious tachycardias. Stress testing allows real-time rhythm analysis under physical stress, helping to determine whether symptoms such as palpitations, dizziness, or syncope are of cardiac origin.

Abnormal blood pressure or heart rate responses during exercise may suggest underlying conduction system issues or autonomic dysfunction, particularly in patients with syncope or bradycardia.
The level of exercise achieved and the speed of heart rate recovery are both powerful indicators of cardiovascular health and long-term outcomes. Poor recovery is associated with an increased risk of future cardiac events, even in patients without significant ECG changes.

A Valuable Tool for Prevention and Performance

In addition to its diagnostic role, exercise stress testing is often used in preventive cardiology and athlete screening. Individuals at risk of heart disease, including those with diabetes, high cholesterol, or a family history of early heart disease, may benefit from periodic stress testing to track changes over time.

It is also commonly used in pre-participation screening for athletes and active individuals—particularly those with symptoms or a family history of sudden cardiac death. Early identification of conditions such as hypertrophic cardiomyopathy or exercise-induced arrhythmias can help prevent life-threatening events during sport or training.

For post-intervention patients, such as those who have undergone angioplasty, stenting, or ablation, stress testing plays an important role in monitoring recovery, fine-tuning treatment, and confirming that the heart is responding as expected.

Take Control of Your Heart Health Today.

A/Prof Saurabh Kumar brings over 15+ years of clinical expertise to the care of patients with heart rhythm disorders and general cardiac conditions. He is widely regarded within the Australian cardiology community and internationally for his depth of knowledge, collaborative style, and commitment to patient-centred care.

He holds dual roles as a Staff Specialist Cardiologist and Cardiac Electrophysiologist at Westmead Hospital and Clinical Associate Professor of Medicine at the University of Sydney. He currently serves as the Program Director for Ventricular Arrhythmias and Sudden Cardiac Death at Westmead Hospital and is the Translational Electrophysiology Lead at the Westmead Applied Research Centre, University of Sydney.

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