Exercise (stress) ECG test protocols Flashcards
absolute indication to terminate a stress test
when the patient requires the premature termination of the exercise test
or
patient request
how many stages does bruce protocol have
7
Determine if it is an absolute or relative indication to terminate a stress test
EKG strongly suggests acute MI
absolute
the meaning of a negative test
patient is safe to be discharged
who has trouble walking at 3.4 mph
short people :(
ventricular ectopy following MI
marker of underlying myocardial ischemia and left ventricular function
a milder protocol is adequate for
patients with known heart disease
patients with recurrent myocardial ischemia,
uncontrolled CHFD
or electrical instability
absolute
Determine if it is an absolute or relative indication to terminate a stress test
abnormally high hypertensive responses are observed
absolute indication
Determine if it is an absolute or relative indication to terminate a stress test
Patient develops significant symptoms or signs
absolute
Determine if it is an absolute or relative indication to terminate a stress test
development of systolic BP of 220 mmHg
relative
disadvantages to Bruce protocol
vigourous exercise work loads
more anaerobic designs
before the stress test you should set up
guidelines for when to stop the test
a vigorous protocol are suitable for
screening healthy individuals
15-40% of patients who come in for post MI stress test have this
limiting angina
>1mm of ST depression have a risk up to
1 year of cardiac death
Determine if it is an absolute or relative indication to terminate a stress test
malfunctioning of equipment
aboslute
Determine if it is an absolute or relative indication to terminate a stress test
diastolic reaches 110mmHg
absolute
primary goal of a stress test after an MI
further diagnostic evaluation and therepy
exercise induces supraventricular tachyarrythmias
relative
30% of patient who have a recent MI experience
ST segment depression and PVCs
sub maximal heart rate of 85%
220 - (age) x .85
Determine if it is an absolute or relative indication to terminate a stress test
systolic BP reses less than 20 mmHg in the first three stages
relative
significant ST abnormalities
2 mm or more of horizontal or down slopping depression
equation for max heart rate
220 - (age)
advantage of Bruce protocol
relatively short in duration
post MI exercise EKG sub maximal post
70%
Post MI max METS
5-7
Determine if it is an absolute or relative indication to terminate a stress test
development of unifocal PVCs
relative
proper selection of the mode of Stress Testing
- goal
- the potential contraindications of method
- results
- influence of conflicting results
significant symptoms which would stop the test
chest pain SOB feeling of syncope hypertensive response ST abnormalities 3 consecutive PVCs
modified light workload protocol
used for patients who have recently had an MI
patients who can’t perform a stress test after 3 weeks of MI are
3-6 times higher mortality rate
ST sement elevation following MI
nonspecific sign
Determine if it is an absolute or relative indication to terminate a stress test
during exercise atrial tachycardia, flutter, Fib with RVR
absolute
how long is each stage in Naughton Protocol
2 mins
in bruce protocol how long is each stage
3 mins
absolute contraindications for post MI stress testing
recurrent myocardial ischemia
uncontrolled congestive heart failure
complex ventricular arrythmias
uncontrolled hypertension
severe aortic stenosis
acute pericarditis or myocarditis
acute pulmonary embolism/infarction
Determine if it is an absolute or relative indication to terminate a stress test
development of serious cardiac arrythmias
(PVC’s, VT/VF)
absolute
recent MI, while exercising to 120 bpm
absolute
