Exercise is a commmon physiologic stress used to obtain _________ ____________ and _________ ___ ________ __________.
cardiovascular abnormalities, adequacy of cardiac function
Exercise electrocardiography is one of the most frequent noninvasive modalities used to assess patients with suspected or proven cardiovascular disease.
True!
The magnitude of ____________ _____________ during exercise depends on severity and amount of muscle mass involved
hemodynamic response
Exercise stress testing is mainly used to get prognosis, determine functional capacity, likelihood of ______ and the effects of therapy
CAD
When are steady-state conditions usually reached at fixed submaximal workloads below anaerobic threshold?
After 2nd minute of exercise
When exercise progresses, total calculated peripheral resistance ____________
decreases
Name the functional classes from healthy and able to do sports to unhealthy, not able to do any activities.
I, II, III, IV
At rest, CO and SV are __________ when the person is in a supine position than when in an upright position
higher
Venous return, LV End diastolic Vol and Press, and SV ___________ when someone goes from supine to upright.
decrease
Gravity decreases blood flow
True!
Exercise performance increases time, HR, and cardiac index by _____ % when going from supine to upright
10%
What are the 3 main types of exercise (protocols)?
Static, dynamic and resistive
Static exercise
isometric
Dynamic exercise
isotonic
Resistive exercise
isometric/isotonic
In general, approx. ___-___ minutes of continuous progressive exercise is optimal for diagnostic/prognostic purposes
12-Aug
__________ exercise exerts muscles at high intensities w/o movement of joints and produces a greater BP response than dynamic exercise
Isometric/static
Increase in HR and BP are proportional to _______ exerted
force
During _______ exercise the patient sustains 20% to 30% of max force for 3-5 minutes while ECG and BP is recorded
static
What kind of exercise keeps joints and muscles moving?
Dynamic (isotonic)
Swimming, walking, bicycling, weight training
All dynamic exercise
What is improved by continuous movements of dynamic exercise?
Blood circulation, strength and endurance
Lifting weights
Resistive
Functional capacity can be overestimated by as much as ___% if patients use handrails
20%
Bruce protocol (treadmill) is used for stress testing in whom?
Healthy people
Modified Bruce protocol, which includes two warm up stages for 3 min at 1.7 mph on the treadmill will be used for whom?
Older people/ people who have cardiac diseases that limit exercise capacity
Uses 1-2 minute stages with 1-MET increments between stages. Used with patients that have limited exercise tolerance (compensated heart failure)
Naughton and Weber protocols
Arm Ergonometry
Arm cranking at 10-20 W for 2 or 3 minute stages
Bicycle Ergonometry
Constant pedaling at 60-80 rpm
Walk test
6 minutes at patient's pace, total distance walked & symptoms
What should patients be advised to do/not do before an exercise stress test?
- DON'T eat, drink, smoke
- Shave hairy chest
- Give history
- Give written consent
What should we do before an exercise stress test?
- Physical exam
- NOT PERFORM if patient is hyper/hypo tensive
(+220/180, - 80 systolic)
- 12 lead EKG in sitting, laying, standing
- EKG before, during, after test
- Instruct patient on how to perform test