exercise testing Flashcards
absolue CI to stress testing(7)
acute MI, High risk UA severe arrhythmia severe sx AS myopericarditis *AO dissection *PE
(6) Relative CI to stress testing
Left main CAD Hocm Mod arrhytmia Mod stnonic VHD BP >200/110 Sig lyte abn
Absolute Indications for termination of EST
- Absolute - patient desire
- angina mod-sev
-BP dec by 10 mmHg + isch
CNS sx
STE > 1 mm aobve baseline
VT
ecg non dx
signs of poor perfusion
At what STD is a relative indication to stop EST
> 2 (this seems too conservative to me)
How much of a bp drop from baseline warrents stopping EST
> = 10 mmHg
WHo has too high or low pretest prob for EST
low females <50 witha typeical
males > 70 with typical sx
Verification bias
only patients are checked if they had cath for sense and spe. This means its probably lower. very rare do cath a negative stress.
How overcome verification bias? (wont be on exam
give everyone a cath
What resduces EST sens
BBs, poor exercise
What reduces est spe
LVH, ST depression atbaseline, dig
What on EST ecg localizes
Only STE
ECG computer analysis does what to ST changes?
exaggerates them
if make EST stage __ and negative ECg likelyhood of CAD is?
< 35%
What is the cut off for very low 15 year death in terms of METS on EST
> =8
What comprises the duke treadmill score
Duration min burces -
5 x st seg deviation in MM -
4x angina index 0, 1, 2
low risk >-5, intermedia +4 to -10 and high < -10
