Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CVTE 112 Final > Stress Testing > Flashcards

Stress Testing Flashcards

1
Q

What is a stress test?

A

A provocative measure to disclose or provoke disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

During a stress test, what is being stressed?

A

The cardiovascular system. Usually cardiac perfusion, via exercise or drugs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Name five methods for stressing: (7 examples given)

A

1) Harvard step test 2) treadmill 3) bicycle ergometer 4) arm ergometer 5) toe raises 6) walk in hall 7) drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Name several indications for stress testing: (6 examples given)

A

*Suspected CAD *detect arrhythmias *evaluate cardiac function *evaluate therapy *LE arterial disease *sports medicine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which is the most common method of stress testing?

A

Treadmill, using Bruce protocol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is MVO2?

A

Myocardial oxygen demand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Define ischemia:

A

Insufficient supply of oxygen to tissue.

Lack of blood flow to tissue.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

In the cardiac cycle, O2 demand is created during _____, and satisfied during ______.

A

Systole

Diastole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What does CAD stand for?

A

Coronary Artery Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What causes CAD?

A

Obstruction of coronary arteries, usually by plaque or clot.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the usual mechanism of M.I.?

A

Rupture of plaque, thrombosis, and sudden occlusion of artery.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How severe must plaque be to cause M.I.?

A

Not necessarily hemodynamically significant.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What implication does that have for the utility of stress testing?

A

It will miss some lesions that can still cause M.I.

May not show up on stress test.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How is cardiac ischemia detected during stress testing?

A

Changes in ECG, specifically in the ST segment.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the ST criteria for stress-induced ischemia?

A

ST depression 2 mm, ST elevation 1 mm, ST slope (maybe), T wave inversion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the J point?

A

End point of QRS complex; marks beginning of ST segment.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are three forms of ST sloping?

A

Downslope. Upslope. Horizontal.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which form of ST sloping is a poor indicator of ischemia?

A

Upslope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is angina?

A

Chest pain (and/or neck-jaw, and/or left arm), usually with exertion.

20
Q

What is stable vs unstable angina?

A

Stable is predictable with given activity level.

Unstable can occur with rest. Bad sign.

21
Q

Is chest pain the only symptom of CAD?

A

No; other symptoms (pressure, SOB, fatigue, etc.) possible, especially in female patients.

22
Q

What test might be combined with treadmill to disclose ischemia?

A

Thallium (nuclear med) perfusion test.

23
Q

Define sensitivity:

A

Ability to call positive when it’s truly positive

24
Q

Define specificity:

A

Ability to call negative when it’s truly negative.

25
Q

What is the overall accuracy (positive and negative) of treadmill testing?

A

Roughly 75%

26
Q

True or false: Since treadmill testing is only about 75% accurate, it isn’t very useful.

A

False, it is still useful. Especially when positive.

27
Q

Name a couple of causes of false positive or false negative with treadmill testing:

A

BBB, MV prolapse, diuretics, previous MI

28
Q

What is the maximum heart rate?

How is it calculated?

A

Predicted max rate heart can achieve.

220-age.

29
Q

What is the target heart rate?

How is it calculated?

A

Rate to shoot for in a test.

Usually 85% of max rate.

30
Q

What test data are/might be collected during a stress test?

A

Duration, heart rate, BP, ST changes, any arrhythmias, possibly oxygen consumption, any anginal pain or claudication, any dyspnea

31
Q

Why is electrode prep important (more than for resting ECG)?

A

All that moving creates ECG noise.

32
Q

What should you monitor carefully during the test?

A

Patient condition

33
Q

What visual cues might be important to note?

A

Breathing, sweating, skin color, ability to talk and interact, facial expression

34
Q

What two aspects of the exercise are changed during the Bruce protocol?

A

Speed and grade

35
Q

How long are the stages of the Bruce protocol?

A

3 minutes

36
Q

How much increase in speed and grade with each stage?

A

About 0.8 mph per stage, 2% grade per stage.

37
Q

What are good reasons to stop the stress test?

A

Positive ECG changes; Reached target HR; Pain, angina or otherwise (like claudication); SOB; Finished all stages! Arrhythmia; Drop in BP; Drop in O2 sat; Patient desires to quit

38
Q

What arrhythmias call for stopping the stress test?

A

V tach; PVC’s (frequent); Paired PVC’s; Heart block develops (2nd or 3rd degree)

39
Q

What is significant about the recovery period?

A

Must watch patient carefully; can be a dangerous period if there’s disease.

40
Q

What condition usually calls for stress testing in the vascular lab?

A

Claudication; LE PAD

41
Q

What forms can the stress for stress testing take?

A

Treadmill; toe-raises; walk hallway

42
Q

What causes a drop in ankle pressure compared to resting?

A

Exercise causes vasodilatation, increased flow through stenosis (and through collaterals), increased loss of energy (ex: pressure)

43
Q

How much drop is mild?

How much drop is severe?

A

20% is mild

50% is severe

44
Q

What ABI suggests the stress test is unlikely to be useful?

A

Less than around 0.40

Arterioles are likely already maximally dilated.

45
Q

How do you calculate the Mean Arterial Pressure (MAP)?

A

MAP = 1/3 pulse pressure + diastolic pressure

CVTE 112 Final (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions