Stress testing Flashcards
It is a tool used to evaluate and manage patient with known or suspected heart disease.
Stress testing
[3] What are the Parameters used in Stress Testing?
- Breathing
- Blood Pressure
- Heart Rate or flow of Blood in the Heart through ECG
AMI means
Acute Myocardial Infarction
A heart attack within 2-3 days.
Acute Myocardial Infarction (AMI)
Chest pain *not previously stabilized by medical therapy.
Unstable angina
Irregular heart beats.
Uncontrolled cardiac arrhythmias
20mmHg
[systole, diastole]
Systole
110 mmHg
[systole, diastole]
Diastole
[3] Main types of Stress test
- Exercise Stress Test
- Pharmacologic Stress Test
- Nuclear Stress Test
Used primarily to assess the etiology of chest pain and for detection of coronary heart disease.
[stress test]
Exercise stress test
AKA Treadmill Stress Test
Exercise stress test
Commonly used.
Exercise stress test
[2] types of Exercise Stress Test
- Treadmill
- Upright bicycle
Most commonly used type of stress test.(Bruce and Modified Bruce)
[exercise stress test]
Treadmill
– Stationary bike, saddle, pedals, handlebars
– Alternative method with an addition of connected electrodes
[exercise stress test]
Upright bicycle
Basis of Stress Test
Target heart rate
Refers to the desired heart rate that the patient should achieve during the test.
Target heart rate
Supporting element for THR; the patient can’t achieve the THR (strengthens the heartbeat).
Digoxin
Reserve for patients who are unable to exercise adequately.
[stress test]
Pharmacologic stress test
Done after exercise stress test.
[stress test]
Pharmacologic stress test
Demonstrated in patients with decreased functional capacity or in patients who cannot exercise.
[pharmacologic]
Induced by pharmacologic agent
[3] Drug used
- Adenosine
- Dypyridamole
- Dobutamine
adenosine analog.
Regadenoson
Increase the blood flow.
Vasodilating agent
Strengthen the force of the heartbeat.
Dobutamine
AKA Myocardial Perfusion Imaging (MPI).
[stress test]
Nuclear stress test
Specifically only used for cardiac test.
[stress test]
Nuclear stress test
A nuclear medicine technique that enhances the sensitivity, specificity, and diagnostic accuracy of exercise ECG stress testing in patients with suspected or known cardiac disease.
[stress test]
Nuclear stress test
Will expose Px to 11 millisieverts of radiation.
Tc - 99
captures images.
Gamma camera
[2] Two parts in Nuclear stress test.
- Resting portion
- Exercise portion
Radioactive tracer delivered through IV.
[portion]
Resting portion
[4] Equipment for stress test
- Treadmill
- Bicycle ergometer
- Blood pressure equipment
- ECG/EKG
Electrically driven and should accommodate a variety of body weights.
[equipment for stress test]
Treadmill
Alternative to treadmill testing (patient that has an orthopedic peripheral vascular or neurological limitation that restrict weight bearing).
[equipment for stress test]
Bicycle ergometer
Less expensive.
[equipment for stress test]
Bicycle ergometer
[2] Two types of Stationary Bikes.
- Mechanically break
- Electronically break
Specific cycling rate to maintain.
[stationary bikes]
Mechanically break
More expensive and less portable, but automated.
[stationary bikes]
Electronically break
2 Types of Blood pressure equipment
- Manual auscultation
- Automated blood pressure
The action of listening to sound from the heart, lungs or other organs, typically with a stethoscope, as a part of medical diagnosis.
[bp equipment]
Manual auscultation
Also known as the Riva Rocci Korotkoff or (manual method for blood pressure measurement) is the listing of Korotkoff sounds in brachial artery.
[bp equipment]
Manual auscultation
An expensive device that may perform erratically at high exercise intensities because of motion.
[bp equipment]
Automated Blood Pressure
Not advisable: result of Diastolic BP may not be accurate.
[bp equipment]
Automated Blood Pressure
Essential for continuous monitoring of heart rhythm an evaluation of ischemic ECG changes during exercise and recovery.
[equipment for stress test]
ECG/EKG
Has Silver-silver chloride electrodes.(recommended)
[equipment for stress test]
ECG/EKG
