CCI Exam Stress

• 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
• 8) thrombophlebitis
• 9) recent embolism, systemic or pulmonary
• 10) high doses of phenothianzine agents
• 11) untreated high blood pressure

• 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

• 1) Bruce
• 2) Modified Bruce
• 3) Balke
• 4) Naughton
• 5) Kattus
• 6) Ellestad
• 7) Ergometer
• 8) Ramp

Most commonly used. Speed and elevation changes

Modified by doctor for patients that are older or have health problems

Speed remains at 3.4 mph, with changes in elevation per stage.

• 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.

-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