CCI Exam Stress
What are contraindications for a Stress Test?
1) Had very recent heart attack (MI)
2) "unstable" angina or angina at rest
3) Dangerous cardiac arrhythmias (V-Tach)
4) Congestive Heart Failure (CHF) with circulatory insufficiency, untreated
5) Severe aortic stenosis
6) Suspected or known disecting aneurysm
7) acute or suspected myocarditits
9) recent embolism, systemic or pulmonary
10) high doses of phenothianzine agents
11) untreated high blood pressure
What are indications for a stress test?
1) To detect coronary artery disease (CAD)
2) Screen patients for symptomatic CAD
3) Help define limits of execise program
4) Identify arrhythmias that occure during exercise
5) Evaluate post MI patients to see if they are at risk for future cardiac events.
6) Determine changes in cardiovascular function after an exercise program, or post surgical treatment (CABG).
7) Identify effectiveness of drug therapy
List protocols used in ExTOLs.
2) Modified Bruce
Describe Bruce Protocol
Most commonly used. Speed and elevation changes
Describe Modified Bruce Protocol.
Modified by doctor for patients that are older or have health problems
Describe Naughton Protocol.
Speed remains at 3.4 mph, with changes in elevation per stage.
List proper prep techniques for an ExTOL test.
1) Prep skin to obtain a good base line.
2) Free skin from body oils and hair
3) Shave hair that may interfere with sensors/electrodes
4) Cleanse electrode sites with alcohol.
5) Use a skin rasp on all sensor sites.
What is the criteria for a postive stress test interpetation?
-J point is the the isoelectric baseline of the ECG
-ST80 (80 ms from J Point) depression of .1mV (1mm) or more
-ST Segment slope within ranger of +1mV/s in 3 consecutive beats
CCI Exam Stress
Stress Test Techniques Indications and Contradictions