Abstract
Exercise testing is an important part of the clinical evaluation of cardiovascular status. In this chapter, we will review the different protocols, indications, and contraindications for this testing. The diagnostic, as well as prognostic, use of exercise testing are explained, with reference to the current ACC/AHA guidelines. The two major exercise test scores—the Duke treadmill and VA predictive score—each provide important prognostication tools for patient care. The chapter includes how to calculate each score and provides an example of using the Duke nomogram with the important variable of age added. The exercise stress test is also compared to other methods of stress testing, such as nuclear perfusion and echocardiogram examinations. Patient characteristics such as beta-blocker use, digoxin use, gender, age, and symptoms require consideration, but do not preclude exercise stress testing. The exercise test is relatively inexpensive, noninvasive, and readily available. It provides both diagnostic and prognostic information and can also help determine functional capacity and degree of disability.
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Notes
- 1.
Pretest probability was determined from the Diamond-Forrester estimates by age, symptoms, and gender (see Table 9.4).
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Recommended Reading
Ashley EA, Forlicher V. The post myocardial infarction exercise test: still worthy after all of these years. Eur Heart J. 2001;22:273–6.
Froelicher VF, Myers J. Exercise and the heart. 4th ed. Philadelphia: W.B. Saunders Company; 1999.
Gibbons RJ, Balady GJ, Bricker JT, Chaitman BR, Fletcher GF, Froelicher VF, et al. ACC/AHA 2002 guideline update for exercise testing: summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to update the 1997 exercise testing guidelines). Circulation. 2002;106:1883–92.
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Uberoi, A.(., Zarafshar, S., Froelicher, V. (2013). Exercise Testing. In: Rosendorff, C. (eds) Essential Cardiology. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6705-2_9
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