Excercise Stress Test

Question 1

MPI RPs

Answer 1

Tl 201 Thallous Chloride
99mTc Sestamibi
99mTc Tetrofosmin
Ru82 chloride
N13 ammonia
F18 FDG

Question 2

How long must the patient continue on the treadmill after RP injection

Answer 2

1-2 minutes

Why? To maintain the maximum myocardial oxygen demand while the tracer is being taken up by the heart

Question 3

Pt prep for exercise stress test

Answer 3

Hemodynamically stable for 48 hrs prior, fast at least 3 hr prior, no physical exertion 12 hrs prior, *may withhold beta and calcium channel blockers 48-72 hrs prior

Question 4

Contraindications to exercise stress test (symptoms)

Answer 4

Unstable angina, acute MI within 2-4 days, uncontrolled hypertension (>220/>120), untreated life-threatening arrhythmias, *maybe beta and calcium channel blockers

Question 5

Contraindications to exercise stress test (diagnosis’s)

Answer 5

Uncompensated CHF, atrioventricular block without a pace maker, acute myocarditis, acute pericarditis, severe mitral or aortic stenosis, severe obstructive cardiomyopathy, acute systemic illness

Question 6

Drugs that can affect exercise stress test

Answer 6

Nitroglycerin
Sedatives
Beta blockers
Calcium channel blockers
Antihypertensives
Diuretics
Digitalis

Question 7

What percent of max heart rate must be met on exercise test?

Answer 7

85%

Question 8

How is target HR calculated?

Answer 8

(220-pt age) x 85%

Question 9

Bruce protocol

Answer 9

Speed and elevation of treadmill increased every 3 minutes

Question 10

Modified Bruce protocol

Answer 10

Elevation slightly increases every 3 minutes, but speed remains slow

Question 11

Big contraindication to exercise

Answer 11

LBBB