Quiz 11 - Exercise Testing Flashcards
What is a graded exercise test?
A test that evaluates one’s physiological response to staged increases in exercise intensity.
What does sensitivity in a medical test measure?
The amount of people who test positive for a disease that they truly have (true positive)
Sensitivity must be at least 70% for a 12 lead ECG GXT
What does specificity in a medical test measure?
The amount of people who truly DO NOT have a disease that is being tested for It proves they are “healthy” in that area.
Specificity must be 80-90% for a 12-lead ECG GXT
Why is a GXT useful?
Bc it evaluates disease severity (if present) with known or suspected CAD - meaning we can see if it got worse, or if it got better.
The magnitude of an ischemia caused by CAD is DIRECTLY proportional to what?
a) degree of ST segment depression
b) # of ECG leads showing depression (i.e. right side, left side or both)
c) duration of ST segment depression in recovery
*Remember - The ischemia will tell you how bad it is. Elevation means whole heart messed up i.e. atria AND ventricles.
When it comes to interpreting data from a GXT what 6 items do you have to evaluate/determine?
- Angina status
- HR response (normal or abnormal due to chronotropic incompetence)
- BP response
- Vo2 max functional capacity
- ECG arrhythmia’s (i.e. irregular signals/beats) & ECG ischemia (i.e. reduced blood flow due to a partial or complete block)
What are the 4 phases of a GXT?
a) pre-test
b) exercise
c) post-test
d) recovery
What does the BORG scale measure?
Rating of perceived exertion (RPE)
What is the 4-level angina rating scale used for?
To rate the subjective pain associated with myocardial insufficiency (most particularly when exercising)
Is it the “big one” - what scale do you feel chest pain on: 1, 2, 3 or 4
what does the Dyspnea scale measure in relation to exercise?
SOB - shortness of breath
When it comes to the HR response to exercise testing, we are looking to see if the heart has what type of response?
-A normal
-Accelerated
(which may be due to de-conditioning; anemia; prolonged bed rest; metabolic disorders; conditions relating to decreased blood volume or low systemic vascular resistance OR autonomic inefficiencies (meaning dysfunctions of nerves that regulate non-voluntary body functions; e.g. HR)
-Chronotopic OR
-Slow recovery
When it comes to BP response to exercise testing, we are looking to see what type pf response?
If BP responds:
a) normal
b) inadequately, due to a rise in SbP
c) thru exercise-induced hypertension - STOP test if so.
When performing a Bruce or YMCA GXT, what are the main things we need to look out for?
ST depression (or elevation), HR, BP, RPE, & any angina
When you get someone to their exercise max too soon during testing that type of fatigue is referenced as what?
Peripheral fatigue (i.e. an over activity-induced decline in muscle function)
What are absolute indications to stop a test?
- Patient request
- Monitoring system failure or malfunction
- Progressive angina (meaning once it reaches 2 or above)
- Vent. Trachy. (V-tach)
- ST elevation
- Signs or symptoms of exercise intolerance (i.e. dizziness, pallor (meaning pale skin) or cyanosis (blue skin), ataxia (meaning abnormal or uncontrolled mov’ts), and/or if a patient is unresponsive.
- Drops of >10mmHg in SBP (despite increase in work rate) WHEN ACCOMPANIED W/ EVIDENCE OF OTHER ISCHEMIAS
