Vasc- exercise testing

Question 1

Patients who complain of claudication only with exercise(ie.intermittent claudication) usually have an ABI close to?

Answer 1

1.0 prior to exercise and an ABI in the 0.6 to 0.8 range following exercise and therefore require additional testing

Question 2

exercise testign steps

Answer 2

• First obtain resting brachial and ankle pressures before exercising
• The patient is positioned on the treadmill platform
• The patient should walk for 5 minutes or until the onset of claudication(The patient will notify the examiner when this occurs)
• If the pain causes the patient to stop,the patient is returned to the exam table and rests in a supine position
• The brachial and ankle pressures are repeated within the first minute after stopping the treadmill
• If a pressure drop is detected at this 1 minute point,then they should be repeated at 2-3 minute intervals(up to 20 minutes) until the ankle pressure returns to pre-exercise levels

Question 3

patients with arterial disease demonstrate what?

Answer 3

a fall in pressure to a point below the pre-exercise level

Question 4

what does exercise testing assess?

Answer 4

the magnitude of immediate pressure drop following exercise and the length of time required for the ankle pressure to return to the pre-exercise level

Question 5

if the ankle pressure is decreased following exercise what occurs?

Answer 5

the test is positive and additional ankle pressure measurements should be taken at 2-3 minute intervals until pressure returns to pre-exercise levels

Question 6

if the ankle pressure returns to normal in a period of 2-6 minutes what does this indicate?

Answer 6

single level disease

Question 7

if the return to resting pressure requires up to 12 minutes what does this mean?

Answer 7

atherosclerotic disease is probably present at multiple levels

Question 8

more than 15 minutes to return to pre-exercise levels indicated?

Answer 8

• ischemic rest pain

Question 9

Reactive hyperemia testing?

Answer 9

• This can be used to stress patients who are not capable of performing a treadmill test(physical instability,heart issues etc)
• This test is not useful in patients who demonstrate an abnormal resting ABI
• It should only be used to evaluate patients who demonstrate a normal resting ABI who complain of pain with exertion
• Treadmill testing is the preferred method of stressing the patient