Exercise Testing Flashcards
Who should go through exercise testing?
- men > 45
- women > 55
- smokers
- sedentary lifestyle
- obese
- HTN
- dyslipidemia
- prediabetic
Absolute CI to participation in exercise testing
- recent significant changes in resting ECG
- unstable angina
- uncontrolled cardiac dysrhythmias
- uncontrolled symptomatic HF
- acute PE or pulm infarct
- severe symptomatic aortic stenosis
- acute myocarditis/pericarditis
- symptomatic severe aortic stenosis
- suspected or known dissecting anuerysm
- acute systemic infection w/ fever, body aches, or swollen lymph nodes
Relative CI to exercise
- L main coronary stenosis
- electrolyte abnormalities
- mod stenotic valvular heart disease
- severe untreated arterial HTN
- HCM
- uncontrolled metabolic disease
High deg AV block - tachy/bradycardia
- advanced/complicated pregnancy
- abnormal increase in body mass previous 2 days w/stable CF
severe arterial HTN at rest
SBP: > 200 mmHg
DBP: > 120 mmHg
Absolute CI when indicate you should stop exercise testing
- onset of angina
- suspicion of MI
- drop in SBP >10 w/increase in work rate
- SBP falls below prior testing
- SP > 250 and/or DP >115
- serious arrhythmias
- significant pulmonary HTN
- Poor Perfusion: pallor, cyanosis, cold/clammy skin
- SOB, leg cramps, claudication
- Patient Request!!
- tech inability to monitor ECG
Relative CI indicating you should stop exercise testing
- failure of HR to increase
- change in heart rhythm
- severe fatigue
- failure of testing equipment
- ventricular aneurysm
submax exercise testing
- patient achieves predetermined exertional level, then stop
- ramped, progressive protocol
- no expired gas analysis performed
- VO2 max or VO2 peak can be extrapolated from the test
how long is each stage of the bruce protocol?
3 minutes
during the bruce protocol, when are physiological measurements taken and then gradient is elevated?
last 30 seconds of each stage
Bruce Protocol: What info can be derived if expired gases are NOT analyzed?
- stage completed
- exercise duration
- HR/RPE/Dyspnea at fixed work loads (stage)
How to estimate VO2peak from Bruce Protocol in Women
(4.38xTime) - 3.9
How to estimate VO2peak from Bruce Protocol in men
(2.94xtime) + 7.65
Tanaka estimation for age specific HR
207 - (.7 x age)
Estimating HRR
HRR = (estimated HRmax - HRrest)
When to stop modified bruce protocol
- achieved pre-determined HR
- 85% of HRmax
- Volitional fatigue
- Patient choice