Exercise Testing

Question 1

ABSOLUTE indications to TERMINATE stress test (8)

Answer 1

Pt requests
drop in systolic BP >10mmHg w evidence of ischemia
severe angina
CNS symptoms (vertigo, visual disturbances, syncope)
Serious arrhythmias (sustained VT/VF)
acute MI
Malfunctioning equipment
8/10 chest pain

Question 2

RELATIVE indications to TERMINATE stress test (8)

Answer 2

marked >2mm horizontal/downsloping ST depression
frequent/multifocal PVC’s
mild CP
fatigue, SOB, leg cramps
drop in systolic BP >20mmHg w/out evidence of ischemia
marked hypertension (220/110mmHg)
failure for BP to rise
Persisting Supraventricular tachyarrhythmias

Question 3

Absolute contraindications (10)

Answer 3

acute MI
unstable angina
Significant LCA stenosis
cardiac arrhythmias
acute myocarditis/pericarditis
severe aortic stenosis
acute or severe CHF
acute pulmonary embolism
Any acute or serious non-cardiac disorders
severe physical handicaps

Question 4

Relative contraindications (10)

Answer 4

clinically significant non-cardiac disorders
significant physical handicaps
debilitated or elderly pts
mentally unstable or uncooperative
severe anemia/high fever
moderate-severe HTN
pulmonary HTN
moderate aortic stenosis
cardiac drugs
fixed rate artificial ventricular pacemaker

Question 5

What does METS stand for?

Answer 5

metabolic equivalent of task

Question 6

How long are the stages in the Blake protocol?

Answer 6

1-minute stages

Question 7

Controllable risk factors for CAD (9)

Answer 7

HTN
poor diet
diabetes
inactivity
smoking
cholesterol
obesity
alcohol
stress

Question 8

Non-controllable risk factors for CAD (4)

Answer 8

age
gender
race
family hx

Question 9

Criteria for terminating post-MI GXT (7)

Answer 9

pt requests
significant symptoms
maximal HR >120bpm
systolic BP during exercise < resting BP
ventricular arrhythmias
lack of HR response
ST segment elevation >1mm or ST sement depression 2mm

Question 10

Naughton protocol speed/grade stages

Answer 10

constant speed, grade increases every 2 minutes

Question 11

Type of stress test for a post MI

Answer 11

submaximal post-MI GXT 70%

Question 12

Repolarization disorders that would need a nuclear test

Answer 12

LBBB
RBBB w/ strain
LVH
WPW
Non-specific abnormality of ST segment/T wave
mitral valve prolapse syndrome
aritifical pacemaker rhythm

Question 13

Indications for a pharmacological stress test

Answer 13

Limiting orthopedic injuriy
musculoskeletal deformities
limiting neurological deficit
limiting peripheral vascular disease
evaluation of CAD w/ inadequate GXT workload
preoperative assessment of pts. awaiting vascular surgery
evaluation of CAD in pts. with fixed LBBB
risk assessment after uncomplicated MI