An exercise test is a safe, supervised assessment of how your child's heart, lungs, circulation and muscles respond to physical activity. The test provides Dr Giardini with information that cannot be obtained while a child is resting, making it an essential investigation for a wide range of symptoms and clinical questions.

The test is typically carried out on a treadmill or a stationary bicycle, depending on your child's age and size. Small adhesive stickers (electrodes) are placed on the chest to record the heart's electrical activity throughout the test, and a blood pressure cuff is fitted to the arm. In some cases a small clip is also placed on the fingertip to measure oxygen levels. Your child will begin exercising at a gentle pace, and the intensity is gradually increased in controlled stages. The clinical team monitors the heart rate, blood pressure, ECG tracing and oxygen levels continuously throughout the test, and your child is encouraged to keep going for as long as they comfortably can. The test is stopped whenever your child needs to stop, and the whole process usually takes around 20 to 30 minutes including preparation and recovery.

Dr Giardini uses exercise testing to investigate a number of common concerns. These include chest pain or palpitations that occur during activity, fainting or dizziness triggered by exercise, unexplained breathlessness (including exercise-induced asthma), and unusual or early fatigue. The test is also valuable for assessing overall fitness and cardiovascular reserve before a child begins an intensive sport or training programme. In children with known heart conditions, exercise testing helps Dr Giardini understand how the heart is coping with physical demands and guides decisions about safe levels of activity.

The test is well tolerated by the vast majority of children. It is carried out in a controlled clinical environment with full monitoring equipment and experienced staff on hand at all times, so you can feel reassured that your child is in safe hands. Most children find the test straightforward and some even enjoy the challenge. You are welcome to stay in the room throughout.

There are a few simple preparations to keep in mind. Your child should wear comfortable clothing and trainers suitable for exercise. It is best to avoid a heavy meal in the two hours before the test, though a light snack is fine. Any regular medications should be taken as normal unless Dr Giardini advises otherwise. Results are discussed with you at the end of the appointment.