CCI Cardiac Stress Testing Protocols 4

Question 1

Which lead configuration is considered most sensitive for detecting stress-induced ischemic ST changes during exercise ECG testing?

Accepted Answer

Leads V4, V5, and V6

Answer

The lateral precordial leads V4, V5, and V6 are most sensitive for detecting subendocardial ischemia during stress testing.

Question 2

A patient with known Wolff-Parkinson-White (WPW) syndrome is referred for stress testing. Which statement about ST changes in WPW during exercise is correct?

Accepted Answer

WPW causes baseline ST abnormalities that make ECG interpretation unreliable during stress

Answer

The delta wave and secondary ST-T changes in WPW render ECG-based ischemia assessment unreliable; imaging modalities should be added for diagnostic purposes.

Question 3

What is the minimum recommended systolic blood pressure threshold at which exercise stress testing should be terminated to prevent hypertensive emergency?

Accepted Answer

220 mmHg

Answer

A systolic BP exceeding 220 mmHg during exercise is a relative indication to stop; >250 mmHg is considered a threshold for mandatory termination to prevent hypertensive crisis.

Question 4

During a nuclear stress test using regadenoson, a patient develops a new fixed perfusion defect compared to rest images. What does a fixed defect most likely represent?

Accepted Answer

Prior myocardial infarction with scar tissue

Answer

A fixed (non-reversible) perfusion defect present on both stress and rest images indicates infarcted, non-viable myocardium.

Question 5

In stress echocardiography, which wall motion abnormality pattern is most consistent with multi-vessel ischemia rather than single-vessel disease?

Accepted Answer

Stress-induced wall motion abnormalities in multiple non-contiguous territories

Answer

New wall motion abnormalities in multiple non-contiguous coronary territories at peak stress indicate multi-vessel disease with widespread ischemia.

CCI - Cardiovascular Credentialing International Practice Test

CCI - Cardiovascular Credentialing International Practice Test

CCI Cardiac Stress Testing Protocols 4