Exercise Stress Testing Flashcards
four reasons to perform cardiovascular testing
diagnosis- determine if they have CAD- help guide decisions of medical treatment
prognosis- identify those pt in whom interventions might improve their outcome
post MI, PTCA, stent- provide activity guidelines
functional capacity- determine return to work or leisure, write an appropriate exercise
what modalitites can be used for testing
TM, bike, UBE
advantages to TM
better to detect ST segment changes and elicit angina
advantages to bike
less money, BP and ECG easier to obtain, balance is less of an issue
advantages to UBE
SCI, amputation, PPS
disadvantages to UBE
VO2 20-30% lower than TM
most widely used protocol
bruce
modified is different from bruce how?
2 stages used prior to starting bruce protocol
consequences of increasing the rate of work too rapidly during testing
overestimation of exercise capacity
less reliable assessment of therapy effects
reduced accuracy for detecting CAD
ramped protocol
uses constant and continuous increase in metabolic demand instead of stages
uniform increase in workload results in steady rise in physiological response and permits a more accurate estimation of VO2
indications, advantages , disadvantages of ECG exercise test
high reliability, cost effective
limitation includes ability to obtain adequate workload and HR response, not as sensitive for dx of CAD
indications, advantages, disadvantages of stress echocardiography
noninvasive, can look at valve prolapse, calculate pressures in chambers, estimate SV and EF
exercise nuclear imaging
expensive, exposure to radiation, can look at true EF and CO, global and regional wall abnormalities
expired gas analysis
can differentiate between heart and lungs, accurate for VO2 max and CO
maximal stress testing
end point is predicted max HR or when pt limited by stress
need physician supervision
can dx CAD
