Exercise Test Flashcards

1
Q

What is the purpose of exercise stress testing?

A

Exercise stress testing assesses a patient’s ability to tolerate increasing exercise intensity while monitoring for signs of myocardial ischemia or abnormal electrical conduction.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Why is testing cardiorespiratory fitness (CRF) important?

A

CRF testing evaluates disease severity, functional capacity, prognosis, and ability to return to physical activity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the necessary steps for preparing a patient for exercise testing?

A

Steps include…

  • obtaining informed consent
  • taking resting vitals
  • conducting symptom assessments
  • explaining the test and expectations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the difference between a graded exercise test (GXT) and an exercise tolerance test (ETT)?

A

GXT measures increasing workload during exercise, while
ETT tests endurance and tolerance at a set workload.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the absolute contraindications to exercise testing?

A

Absolute Contraindications:

  • Acute MI within 2 days
  • Ongoing unstable angina
  • Uncontrolled cardiac arrhythmia with hemodynamic compromise
  • Symptomatic severe aortic stenosis
  • Decompensated heart failure
  • Acute pulmonary embolism, pulmonary infarction, or DVT
  • Acute endocarditis, myocarditis or pericarditis
  • Acute aortic dissection
  • Physical disability that precludes safe and adequate testing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the relative contraindications to exercise testing?

A

Relative Contraindications:

  • Known obstructive left main coronary artery stenosis
  • Moderate to severe aortic stenosis with uncertain relationship to symptoms
  • Tachyarrhythmias with uncontrolled ventricular rates
  • Acquired advanced or complete heart block
  • Recent stroke or transient ischemia attack
  • Mental impairment with limited ability to cooperate
  • Resting HTN with systolic >200mmHg or diastolic >110mmHg
  • Uncorrected medical conditions such as significant anemia, important electrolyte imbalance, and hyperthyroidism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When is physician supervision recommended ?

A
  • Moderate to severe aortic or mitral stenosis in an asymptomatic or questionably symptomatic patient
  • Hypertrophic cardiomyopathy
  • History of malignant or exertional arrhythmias
  • History of exertional syncope or presyncope
  • Intracardiac shunts
  • Within 7 days of MI or another acute coronary syndrome
  • NYHA Class III Heart Failure
  • Severe left ventricular dysfunction and recent deterioration
  • Severe pulmonary arterial HTN
  • Other potential instabilities resulting from Non cardiovascular comorbidities (Frailty, dehydration, orthopedic limitations, COPD)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the…

  • Borg RPE scale = ?
  • Angina scale = ?
  • Claudication scale = ?
A

The Borg RPE scale measures perceived exertion during exercise, helping monitor exercise intensity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the indicators for stopping an exercise test?

A

Signs like severe angina, significant drop in systolic BP, cyanosis, or dizziness indicate the test should be stopped.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the absolute indicators for stopping a test?

A

Absolute indicators:

  • Drop in SBP > 10 mmHg from baseline despite increase in workload with other evidence of ischemia
  • Moderately severe angina (3-4 on angina scale)
  • Increasing nervous system symptoms (ataxia, dizziness)
  • Signs of poor perfusion (cyanosis, pallor)
  • Sustained ventricular tachycardia
  • > 1.0 mm ST elevation in leads without diagnostic Q wave (STEMI)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the difference between a maximal and submaximal exercise test?

A

Maximal tests require the patient to exercise to fatigue, while submaximal tests estimate VO2 max based on heart rate response.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How is VO2 max estimated in a submaximal test?

A

VO2 max is estimated using heart rate response to graded exercise, assuming a linear relationship between HR and work rate.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the characteristics of the Bruce Protocol?

A

The Bruce Protocol is a treadmill-based test with 3-minute stages, increasing speed and incline to assess CRF.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the Queens College Step Test, and how is it performed?

A

The Queens College Step Test involves stepping on a 16.25-inch step for 3 minutes to estimate VO2 max.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the purpose of the 1-Mile Walk Test, and how is it conducted?

A

The 1-Mile Walk Test assesses endurance by measuring the time and heart rate required to walk 1 mile as fast as possible.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the difference between a fixed distance test and a fixed time test?

A

Fixed distance tests assess how quickly a patient can complete a set distance, while fixed time tests measure how far they can go in a set time.

17
Q

What is the YMCA Cycle Ergometer Test, and how is it performed?

A

The YMCA test involves cycling at a constant pace while increasing resistance, monitoring heart rate to estimate VO2 max.

18
Q

What are field tests, and how do they differ from laboratory-based tests?

A

Field tests are completed in non-laboratory settings and are often less expensive and easier to perform than lab-based tests.

19
Q

How is MET level tolerance determined through exercise testing?

A

MET level tolerance is determined by measuring the VO2 max during exercise and converting it to METs (1 MET = 3.5 mL O2/kg/min).

20
Q

How are heart rate and VO2 max data interpreted in exercise testing?

A

Heart rate and VO2 max are used to assess the patient’s cardiovascular fitness and prescribe appropriate exercise intensity.

21
Q

What is the Jackson Non-Exercise Test, and how is it used to estimate VO2 max?

A

The Jackson Non-Exercise Test uses demographic information and physical activity history to estimate VO2 max without exercise.

22
Q

How is heart rate recovery measured and interpreted?

A

Heart rate recovery is measured by the decrease in heart rate after exercise, with slower recovery indicating potential cardiovascular risk.

23
Q

What are the key safety considerations during exercise testing?

A

Safety considerations include monitoring for adverse symptoms, having medical equipment ready, and using proper test protocols.

24
Q

How do you monitor heart rate, blood pressure, and other vitals during an exercise test?

A

Heart rate and blood pressure are monitored continuously, along with symptoms like fatigue, chest pain, and dyspnea.

25
Q

What is the importance of reaching a steady-state heart rate during testing?

A

Reaching steady-state heart rate ensures accurate assessment of cardiovascular fitness and exercise tolerance.

26
Q

How are exercise testing results used to guide exercise prescription?

A

Results from exercise testing help determine safe and effective exercise intensities for rehabilitation and fitness programs.