Exercise Tolerance Testing

Question 1

Who first recorded the connection between ST depression and angina, and on what year?

Answer 1

Feil and Siegel reocrded the first instance in 1928.

Question 2

How did Bruce contribute to the development of stress testing?

Answer 2

Bruce invented calibrated protocols and aerobic principles.

Question 3

What are 12 signs that a person could use an ETT?

Answer 3

1. post-MI
2. post-CABG
3. post-cardiac surgery
4. tease out arrhythmias
5. create exercise prescription
6. chronic lung disease
7. CKD
8. PVD
9. post-angioplasty
10. post-valve replacement
11. evaluation of high-risk person
12. evaluate suspected heart disease

Question 4

Under which condition should an exercise test be halted, without question (8 answers)?

Answer 4

1. drop in SBP >10mmHg from baseline + other sx ischemia
2. moderate-severe angina
3. nervous system abnormalities (clumsiness, dizziness, near syncope)
4. signs of poor perfusion (cyanosis, pallor)
5. technical difficulties in monitoring ECG or BP
6. pt wants to stop
7. sustained vTach
8. ST elevation without q-waves (except in V1 or aVR)

Question 5

When testing for CAD, what class do people with baseline WPW, pacemaker rhythms, >1mm ST depression, or LBBB fall under?

Answer 5

Class III

Question 6

Which 9 findings indicate severe ischemic heart disease?

Answer 6

1. ST depression developing before 3min exercise time
2. ST depression >2.5mm
3. downsloping ST depression
4. ST elevation
5. ST depression >8min into recovery phase
6. serious arrhythmias developing at <130 bpm heart rate
7. chronotropic incompetence
8. > 10 mmHg drop in SBP during exercise
9. inability to exercise longer than 3min