Cardiac Exercise Methods

Question 1

Indication with suspected angina pectoris/CAD when doing exercise method

Answer 1

to establish or confirm the diagnosis

Question 2

indication with known angina pectoris/CAD when doing exercise method

Answer 2

• assess cardiovascular functional capacity
• detect exercise induced cardiac rhythm disturbances
• evaluate the response to conditioning and prevention programs
• to evaluate the response to treatment, such as medication PTCA, CABG

Question 3

Requirement of Cardiac exercise method

Answer 3

• Patient must be able to exercise to achieve 85% of their maximum heart rate
• beta blocker medication should be stopped 24-48 hrs prior to exercising

Question 4

Patient prep for exercise method

Answer 4

baseline ECG/Blood pressure
Procedure explain and consent form

Question 5

What are equipments?

Answer 5

• treadmill/bicycle

Question 6

what formula to calculate maximum heart rate and what protocol does it based on?

Answer 6

(200-pt age)x 85%
based on Bruce’s protocol for normal/healthy patients
the modified Bruce protocol for older or individuals with the limited exercising capacity

Question 7

what patient prep for diabetic patients?

Answer 7

diabetic patients should be carefully evaluated and instructed appropriately before fasting

Question 8

modified Bruce vs normal Bruce

Answer 8

• start with 2 warm-up phases at the lower speed with 0 elevations.
• normal bruce protocol the speed and elevation increase every 3 mins called stage which represents the increase in workload and heart rate

Question 9

What issues may we be looking for when evaluating baseline ECG for Cardiac Exercise Stress Test Methods?

Answer 9

• AV block: atrial depolarization fails to reach the ventricles whcih can result is delayed ventricular contraction
• Atrial problems
• Left bundle Branch Block

Question 10

indication to stop exercise?

Answer 10

1. marked arrhythmia induced by exercise
2. decrease BP >20mmhg below the starting BP
3. extremes elevation in blood pressure systole >250mmhg and diastole >120mmhg
4. severe chest pain, marked dyspnea and dizziness
5. greater than 85%
6. sever ST depression > 3mm or 1mmST elevation inleads without pathologic Q waves
7. bundle branch block
8. failure monitoring system
9. severe fatigue, leg pain or breathlessness