what are Exercise Tests needed for diagnosing?
– Myocardial ischemia, coronary atherosclerosis
– Individuals in asymptomatic middle-aged strong risk group
– Distinction of chest discomfort
– Asymptomatic post MI patients
– Syncope assessment
what are the 2 types of exercise tests?
field test
CPET
give examples for field test
and CPET
field, 6 minute walk test (6MWT)-Shuttle walk test-3 minute step test
CPEET, Treadmill Cycle ergometer-Maximal-Submaximal
what are the contraindication of exercise testing?
- Acute MI (within 2 days)
- High-risk unstable angina
- Uncontrollable arrhythmia
- Decompensated symptomatic heart failure
- Acute pulmonary embolism or infarction
(renal insufficiency)
- To evaluate the specific symptoms / findings of
exercise - To determine abnormal responses to exercise in
cardiac, pulmonary / other organ disorders - To evaluate the effect of treatment & surgery
- To evaluate the functional capacity
- To evaluate the prognosis
- Planning a cardiac, pulmonary, musculoskeletal
rehabilitation program
are?
are all aims of CPET
when we should terminate the test?
- Ischemic chest pain
- Ischemic changes in ECG (> 2 mm ST elevation)
- Complex ectopia (ventricular tachycardia)
- 2-3. degree heart block
- Decrease of sistolic BP more than 20 mmHg ’
- Hypertension
- Severe desaturation (SpO2 less than 80% + signs and symptoms of
severe hypoxemia - Sudden pallor
- Loss of coordination
- Mental confusion
- Dizziness, syncope
- Respiratory failure findings (cyanosis, severe shortness of breath)
Systolic pressure decrease more than 20mmHg
is a sign to stop CPET
true or false?
false, decrease more than 10mmHg
- Increase in chest pain
- Fatigue, shortness of breath, wheezing, muscle cramps
- Less severe arrhythmia such as supraventricular tachycardia
- Excessive increase in the peak value of heart rate according to
pre-performed exercise tests - Significant ECG changes (2mm ST segment depression,
elevation)
are relative terminate criteria to which test?
CPET
what are the equipment of exercise testing?
- Treadmill
- Cycle ergometer
- Oxygen consumption
meter - Spirometry
- 12-lead ECG
- Pulse oximeter
- Anaroid
sphygmomanometer - Polar heart rate
monitor - Chronometer
- Modified Borg scale
- Visual analogue scale
- Patient bed
what can we use for safety during testing?
- 2 agonist inhaler
- Adrenalin
- ET intubation,
Assisted ventilation
devices - Defibrillator
- Oxygen supply
Treadmill are cheaper, takes up less space, makes little noise and is portable
true or false?
false, ergometer
for CPET progressive protocol is like?
- 8-12 min
- Multi-step: every 2-3
minutes - Progressively increasing
every 1 min - Constantly increasing:
Ramp
for Bruce protocol CPET treadmill
the speed and incline are increased every 5 mi
true or false?
false, every 3 min
in Balke protocol which one is constant and the other is increased?
the speed is constant= 3.5 mph
Incline increased (% 2)
which protocol is a
submaximal study which is used for
high-risk patients?
The Naughton
which protocol may require high levels of
running?
Ellestad protocol
The pedal frequency should be how much for cycle ergometer CPET?
50-60 rpm
person is selected to bring the
maximal effort to 8-12min in CPET: Cycle ergometer
true or false?
true
12-lead ECG recording every 3 min
* Blood pressure measurement at the last minute of each test step
* Use of scales for symptoms (dyspnoea and angina scales
are ?
Measurements During Test
Minimum 6 min sitting, lying in supine position or waiting until you reach initial values
* 12-lead ECG recording every minute after testing
* Blood pressure measurement every minute until it reaches the normal value after the test ends
are measured during cooling or warming period true or false?
true
Peak VO2
Ventilator anaerobic threshold
Blood pressure
Oxygen pulse
Breathing frequency
what are the predicted values for these parameters?
Peak VO2, >% 84
Ventilator anaerobic threshold, >% 40
Blood pressure, <220/90
Oxygen pulse, >% 80
Breathing frequency,<60 breath/min
Maximal HR is equal to?
220-age
Cardiovascular diseases
or Anemia, arterial hypoxemia, metabolic
can be seen with O2 pulse less than 80%
true or false?
true
what is the normal for Anaerobic threshold?
% 40-50 VO2max
