Stickers are placed on the chest to record the electrical activity of the heart. You are then asked to walk on a treadmill whilst your blood pressure and heart rate are monitored. 

This is recommended in many patients with severe valve disease and normally functioning left ventricles who genuinely have no symptoms – even after a careful ‘history’- as this test is able to ‘unmask’ hidden symptoms.  A patient whose exercise capacity is shown to decrease over time on sequential exercise tests may be referred for valve intervention, even if they are unable to recognise symptoms themselves.