Cardiopulmonary CPET

Question 1

Indications for a clinical exercise test encompass 3 general categories including

Answer 1

• Diagnosis
• Prognosis
• Evaluation of the physiologic response to exercise

Question 2

Describe a maximal test

Answer 2

• Use the end point of the patient’s maximal APMHR (achievement of predicted maximal heart rate) or terminate when pt is limited by sx
• Used to measure functional capacity & diagnose CAD

Question 3

Standard testing procedures require a _____-lead ECG to rule out any acute ischemia or injury ___________ testing

Answer 3

• 12-lead
• Before

Question 4

Variables that are typically monitored during clinical exercise testing include

Answer 4

• Heart Rate
• ECG
• Blood Pressure
• RPE
• Clinical signs & individual reported sx

Question 5

Postexercise & safety following a clinical exercise test

Answer 5

• Low intensity active recovery to support venous return & hemodynamic stability

Question 6

Normal HR response to incremental exercise is to

Answer 6

• Increase with increasing workloads at a rate of ~10 BPM per 1 MET

Question 7

Normal blood pressure response to exercises is to

Answer 7

• Increase with increasing workloads at a rate of ~10 mmHg per 1 MET
• Normally no change or a slight decrease in diastolic BP during an exercise test

Question 8

The normal response of the ECG during exercise includes the following:

Answer 8

• P-wave: increased magnitude among inferior leads
• QRS: Duration decreases, septal Q-waves increase among lateral leads, R waves decrease, and S waves increase among inferior leads.

Question 9

A high exercise capacity is indicative of a high peak Q and therefore suggests the absence of serious limitations of ________ ventricular function.

Answer 9

• Left

Question 10

Various criteria have been used to confirm that a maximal effort has been elicited during a GXT (graded exercise test)

Answer 10

• A plateau in VO2 peak
• Failure of HR to increase with increases in workload
• A postexercise venous lactate concentration >8.0 mmol . L−1
• RPE at peal exercise >17 (6–20 scale) or >7 (0–10 scale)
• A peak RER ≥1.10

Question 11

When is a pharmacological stress testing used

Answer 11

• Used when a patient is unable to perform upright exercise on a treadmill or stationary bicycle
• Most common agents: adenosine, dipyridamole, dobutamine, & regadenoson

Question 12

Describe field walking tests

Answer 12

• Considered sub maximal
• Used to evaluate exercise capacity, estimate prognosis, & evaluate response to treatment
• Includes 6MWT, incremental, & endurance shuttle walk tests