Exercise testing in pediatric cardiology.

Exercise testing in pediatric patients differs in many aspects from the tests performed in adults. Diseases that are associated with myocardial ischemia are very rare in children. Their cardiovascular response to exercise presents different characteristics, particularly maximal heart rate and blood pressure response, which are essential in interpreting hemodynamic data. The main indications for exercise testing in children are evaluation of exercise capacity and identification of exercise-induced arrhythmias. There are many testing protocols, but the Bruce protocol is widely used in many pediatric cardiac centers. In this article the authors describe the main indications for exercise testing in children with congenital heart disease, the contraindications for exercise testing and the indications for terminating an exercise test.