Non-Invasive Cardiac Diagnosis

Question 1

Bruce protocol:

Answer 1

• common protocol of exercise testing in practice and research
• increase in speed and gradient concurrent with 3 min increments
• modified bruce procol for elderly and those with cardiac conditions
• maximal prediced HR for age = (220-age)
• if patient cant achieve 85% then this study is nondiagnostic

Question 2

Cardiac MRI

Answer 2

• ability to perform chamber and wall dimension measuement
• can evaluate wall composition for scar formation after infarct, myocarditis, and infiltrative disease of the myocardium
• may not be able to perform in those with pacemakers or defibrilators

Question 3

Contraindications for stress testing:

Answer 3

• acute MI within 2 days
• high risk unstable anina
• uncontrolled cardiac arrhythmia with hemodynamic compromise
• active endocarditis
• symptomatic severe aortic stenosis
• decompensated heart failure
• acute pulmonary embolism or pulmonary infrrction
• acute myocarditis or pericarditis
• physical disability precluding safe and adequate testing