Duke Treadmill Score Calculator

Duke Treadmill Score Calculator for Cardiology. Scores at least 5 are in the historical lower-risk group; scores at most -11 are in the higher-risk group. All values strictly between -11 and 5 are intermediate. The output does not convert those cohort categories into personal annual mortality.

For shared guidance on choosing a tool and documenting results, read the clinical calculator workflow.

How this calculator works

Duke score = exercise minutes - 5 x maximal ST deviation in mm - 4 x angina index. The index is 0 without angina, 1 with nonlimiting angina and 2 when angina stops the test. Fractional minutes and millimetres are retained.

When to use this calculator

To summarize an appropriate, clinician-supervised standard Bruce exercise ECG. The test report must establish that ST changes are interpretable and that duration refers to the relevant protocol.

Inputs used

  • Standard Bruce-protocol exercise duration (minutes)
  • Maximum absolute exercise/recovery ST deviation (mm)
  • Exercise angina: absent, present but nonlimiting, or test-limiting

Clinical interpretation

Scores at least 5 are in the historical lower-risk group; scores at most -11 are in the higher-risk group. All values strictly between -11 and 5 are intermediate. The output does not convert those cohort categories into personal annual mortality.

Worked example

At 9.5 minutes, 1 mm deviation and no angina: 9.5 - 5 - 0 = 4.5, in the intermediate band. Ten minutes with the same ST finding gives exactly 5, entering the lower-risk band. With 7 minutes, 2 mm deviation and limiting angina, the score is -11.

Limitations and safety notes

Not a coronary-artery diagnosis, exercise clearance or an ACS triage rule. Different exercise protocols, uninterpretable baseline ECGs, pacing and test-limiting noncardiac problems can make the model unsuitable. Numeric input limits prevent obvious entry errors but do not establish clinical eligibility.

Frequently asked questions

Is 4.5 rounded into the lower-risk band?

No. Classification uses the unrounded result; 4.5 is below 5.

Can I substitute modified Bruce minutes?

Not directly. This implementation uses standard Bruce duration and does not convert other protocols.

References

  • Mark DB et al. Exercise treadmill score for predicting prognosis in coronary artery disease. 1987. https://doi.org/10.7326/0003-4819-106-6-793
  • Mark DB et al. Prognostic value of a treadmill exercise score in outpatients with suspected coronary artery disease. 1991. https://pubmed.ncbi.nlm.nih.gov/1875969/
  • AHA. Exercise standards for testing and training. 2013. https://doi.org/10.1161/CIR.0b013e31829b5b44

Editorial review and citation methodology

Maintained by the Quick Medical Calculator Editorial Team. Content record date: September 9, 2026. A content date is not evidence of independent clinical review. Individual clinical sign-off is not recorded on this page.

  • Prefer original validation studies for scoring systems and prediction tools.
  • Use current specialty society guidance, transplant allocation policy, public health guidance, or regulator resources when they govern clinical use.
  • Include limitations and safety notes when a calculator is population-specific, context-dependent, or unsuitable as a standalone decision tool.

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