Stress Test Flashcards
This is defined as a tool used to evaluate and management patients with known or suspected heart disease
Stress test
TRUE OR FALSE:
Stress test determine the range of ability of the heart
TRUE
What disease is checked using Stress Test?
Coronary artery disease
What is the most important condition causing abnormality in ST segment?.
Myocardial infarction or ischemia
What is the main aim of stress testing?
assess coronary flow system and measure ability of heart to response to stress
TRUE OR FALSE:
Stress testing can be induced through the use of drugs or exercise
TRUE
Stress test is monitored though the use of __________________
electrocardiogram or electrogardiography
Who are the patients who are tested using stress test?
Patients who suffer from arrythmia, complains of chest pain, difficulty in breathing
WHat is the test used to detect narrowed arteries?
Coronary angiogram
TRUE OR FALSE:
Medications may be reuqired to stop for intake
TRUE - depends on physician
Eating and smoking should be stopped ___________ hrs before the stress test
2-4hrs
Drinking caffeinated drinks may cause ___________
palpitations
What should not be applied when preparing for nuclear stress test?
Oil, lotion, cream
Stress test lasts for _________
1hr
Pharmaceutical stress test mimics ___________
exercise = increase blood flow
TRUE OR FALSE:
Stress testing can be stopped anytime if you’re too uncomfortable to continue exercising
TRUE
What are the signs and symptoms that are reasons to stop the test?
- moderate to severe chest pain
- Severe shortness of breath
- Abnormally high/low blood pressure
- Abnormal heart rhythm
- Suffer fatigue/dizziness
- Certain changes in ECG
TRUE OR FALSE:
Patients can do their normal activities after the stress testing
TRUE - depends on the result
TRUE OR FALSE:
Patients may be required to Stand still for several seconds and then lie down for a period of time with the monitors in place
TRUE
Acute myocardial infarction is a contraindication if it occurred within ________________
2-3 days
TRUE OR FALSE:
Unstable angina (chest pain) not previously stabilized by medical therapy is NOT considered a contraindication
FALSE
Which type of angina occurs even if a person is not doing anything?
Variant or Prinzmetal angina
If the blood pressure of ___________________ is indicative of severe hypertension
Diastolic >100mmHg, Systole: >200mmHg or both
TRUE OR FALSE:
Inflammation of the heart is a contraindication for stress test
TRUE
Which are other contraindications of stress test?
- Acute aortic dissection
- High grade AV (atrioventricular) blocks
- Symptomatic severe aortic stenosis
- Acute pulmonary embolism/Pulmonary infarction
- Uncontrolled symptomatic heart failure
Which stress test has the possibility to induce allergic reaction but is rare?
Nuclear ST
TRUE OR FALSE
Treadmill stress test is very risky
FALSE
It has very little risk
A positive stress test indicates ______________
advanced coronary artery disease
TRUE OR FALSE:
Heart attacks initially has SIGNIFICANT stress test result
FALSE
It is NOT SIGNIFICANT
What are the main types of stress test?
Exercise/Treadmill, Nuclear, Pharmacologic Stress test
Which among the types of stress tests is the most common and widely used type?
Exercise/Treadmill
What is the alternative used for treadmill?
Upright bicycle
What are the common test protocol for treadmill?
Bruce and modified bruce
How long is the warm uo stages for the stress test protocol lasts?
3 mins
TRUE OR FALSE:
Exercise stress test is cheaper than nuclear stress test
TRUE
TRUE OR FALSE:
Stress test is used for patients who has normal finding in resting ECG
TRUE
TRUE OR FALSE:
Nuclear stress test requires the wearing of a mouth piece after the test to measure the air you will breathe out
FALSE
- it is needed for exercise/treadmill ST
Which equipment is used along while performing exercise stress test to record heart beat and waves?
ECG
What does the IV contains that is used for nuclear stress test?
Radioactive tracer
TRUE OR FALSE:
NuclearST is dangerous and can cause complications
FALSE
Life threatening complication from Nuclear ST occurs at 1/10,000
What are the two portions when performing nuclear stress test?
during exercise/pharmalogic and while at rest
What is the previous radioactive used?
Thallium-201
What is the new radioactive used currently?
Tecnicium-99
Why is Tc-99 more preferred to use?
It provides clearer images and less exposure to radiation
What is the half-life of Tc-99?
6hrs
Tc-99 will expose you to ___________________ of radiation
11 millisieverts
How is Tc-99 excreted from the body?
Feces
What is the imaging used to capture images?
Myocardial Perfusion imaging (gamma camera)
TRUE OR FALSE:
BOTH nuclear ST and pharmacological ST is used for patients who are unable to exercise adequately
TRUE
What are the imaging modalities used in pharmacological ST?
Radionuclide imaging and echocardiography
What are the drugs used to induce physiological stress?
Vasodilators (adenosine, dipyridamole)
Inotropic drugs (dobutamine)
In general, what drug is more preferred for pharmacological ST?
Vasodilators
What is the analogue of adenosine?
Regadenoson (has longer half-life)
What are the machine and equipment used for stress testing?
Treadmill, electrocardiogram, bicycle ergometer, and BP equipment
This equipment keeps track of heartbeat during test and tell the camera when to take a picture
Electrocardiogram (ECG)
How much weight should a treadmill can accomodate?
up to 350lbs or 157.5kgs
TRUE OR FALSE:
Obese patients are advised not to use exercise/treadmill ST
TRUE
Emergency stop button must be __________________
easily accessible and visible by both Px and staff
What is the range of speed for treadmill must have?
1.6km (1mph) to 12.8km (8mph)
Up to what degrees should the elevation of the treadmill can do?
20%
What is the minimum treadmill platform length?
Length: 127cm or 50inches; Width: 40.64cm or 16inches
This equipment is used for continuous monitoring of heart rhythm and evaluation of ischemic ECG changes
Electrocardiogram (ECG)
How to know if the ECG used is acceptable for stress testing?
For as long as specification set by the American Heart Association is met
TRUE OR FALSE:
Inaccurate frequency response may lead to false results
TRUE
How to check for validity of data?
Compare raw analogue data to computer generated data
What is used to produce interpretation clinically the ECG?
12-lead ECG
TRUE OR FALSE:
ECG equipment is needed in every laboratory
FALSE:
Not essential in every laboratory but practical in population with high risk for heart disease to have automatic arrythmia detectors
What is the electrodes used for ECG?
Silver-Silver Chloride
What is capable of minimizing motion artifact?
Silver-Silver Chloride, light weight shielded cables worn around the waist, flexible knit tube shirts
Which is more expensive, treadmill or bicycle ergometer?
treadmill
Bicycle ergometer is used for orthopedic patients who has _________________
peripheral vascular or neurological limitations
TRUE OR FALSE:
Bicycle ergometer’s work rate can be adjusted
TRUE
What is the unit used to calculate work rate?
watts or kilopond-meters per min-1
What are the two types of bicycle ergometer?
Mechanically and electronically brakes
Between the two types of bicycle ergometer, which needs to maintain specified cycling rate?
Mechanically braked
What are the required physical set up of bicycle ergometer?
Handlebars, adjustable seat, Adaptable pedal grips, meters, dials, digital display
WHat is the ideal seat height for bicycle ergometer?
knee should be slightly flexed at full extension
What compares treadmill and bicycle ergometer?
When using bicycle the maximum oxygen uptake of Px is lower than 5-20% compared to treadmill
Which BP equipment is most feasible and easy to use, and more reliable?
Manual auscultation
TRUE OR FALSE:
Automated BP is the most reliable and recommended BP equip
FALSE - it can perform eratically during high exercise intensity where diastolic may not be accurate
TRUE OR FALSE:
BP cuffs are disposable
FALSE
It must be regularly cleaned and inspected
This BP equipment is recommended than aneroid manometer however not available anymore. It is more accurate and reliable, easy to calibrate
Mercury manometer
Manometer is placed __________________
at the level of Px’s heart