stress test

Question 1

Angina (chest pain) was first described in ______ by ______

Answer 1

1772 by William Heberden

Question 2

it represents the interval
between ventricular depolarization and repolarization

Answer 2

Electrocardiogram (ecg)

Question 3

ST depression first noted during angina

Answer 3

(Bousfield) in 1918

Question 4

ST changes during exercise (sit ups) are associated with chest pain
& decreased cardiac blood flow

Answer 4

(Feil & Siegel) in 1928

Question 5

Master’s Step test, first “standard” exercise protocol

Answer 5

Arthur Master in 1929

Question 6

ST depression is present in only 75% of patients with angina during
exercise (similar to percentages today)

Answer 6

Goldhammer & Scherf in 1932

Question 7

First to use maximal exercise testing to test for CAD → climbing stairs

Answer 7

(Morris Missal) in 1938

Question 8

Support the study of Bousfield through ST segment
depression

Answer 8

Riseman et al. in 1940

Question 9

Sensitivity of post-exercise ECG

Answer 9

Master & Jaffe in 1941

Question 10

The Harvard Step Test used to assess fitness from HR during
recovery.
Measures endurance, develop during second world war.
Type of cardiac step test for detecting and diagnosing cardiovascular disease

Answer 10

(Johnson et al in 1942

Question 11

Maximal exercise (stair climbing) was more sensitive (88%) to
detect CAD than submaximal exercise (39%) (

Answer 11

Wood et al in 1950

Question 12

Treadmill testing used with set criteria to screen for CAD

Answer 12

(Yu et al. in 1952

Question 13

Astrand test → a submaximal cycle ergometer aerobic fitness
test based on relationship between heart rate during work and
percentage of maximal aerobic capacity

Answer 13

Astrand, P.-O. & Ryhming in 1954

Question 14

established the guidelines used today: treadmill, with
EKG, during exercise
* Exercise protocol to classify according to New York Heart
Association Criteria
* Initiate Contemporary era of exercise testing for diagnostic
and prognostic purposes

Answer 14

robert bruce in 1956

Question 15

o measure heart’s ability to respond
to external stress in a controlled clinical environment

Answer 15

stress testing

Question 16

Types of Stress Testing

Answer 16

• Exercise
• Pharmacologic
• nuclear

Question 17

example of Pharmacologic

Answer 17

• regadenoson
• dobutamine
• persantine
• adenosine

Question 18

most common test used

Answer 18

exercise stress test

Question 19

it usually involves walking on a treadmill or riding a
stationary bike

Answer 19

exercise stress test

Question 20

Indications of Exercise Testing

Answer 20

Diagnose coronary artery disease
Diagnose heart rhythm problems

Question 21

risks of the test

Answer 21

low blood pressure
abnormal heart rhythm
heart attack

Question 22

Used sticky patches (electrodes) on chest legs and
arms

Answer 22

treadmill test

Question 23

Treadmill protocols

Answer 23

✓ Bruce
✓ Cornell
✓ Balke ware
✓ Acip
✓ mAcip
✓ Naughton
✓ Weber

Question 24

commonly used treadmill protocols

Answer 24

bruce

Question 25

it has 3-minute periods to allow achievement of a steady state before work-load is increased for next stage

Answer 25

Bruce Protocols

Question 26

Termination of Exercise Testing

Answer 26

o Moderate to severe chest pain o Severe shortness of breath o Abnormally high or low blood pressure o An abnormal heart rhythm o Dizziness o Fatigue o Certain changes in your electrocardiogram

Question 27

A flat or down sloping depression of the ST segment > 0.1 mV below baseline

Answer 27

positive test

Question 28

▪ Target heart rate is not achieved ▪ 85% of maximal predicted heart for age and sex is not achieve

Answer 28

negative test

Question 29

limitation of treadmill stress test - Sensitivity

Answer 29

68%

Question 30

limitation of treadmill stress test - Specificity

Answer 30

77%

Question 31

if symptoms are normal, and results continue to worsen the doctor might recommend

Answer 31

nuclear stress test

Question 32

more accurate, but more expensive

Answer 32

nuclear stress test

Question 33

Not used in cases in patient with asthma or Chronic obstructive pulmonary disease

Answer 33

Vasodilators such as: Adenosine and Dipyridamole

Question 34

Makes heart response as person is exercising

Answer 34

Dobutamine

Question 35

NUCLEAR STRESS TEST also known as

Answer 35

“Myocardial perfusion imaging

Question 36

what instrument is injected in the arm of the patient

Answer 36

radiotracer