Exercise Testing Flashcards

Which exercise test protocol is most appropriate for elderly or severely deconditioned cardiac rehabilitation patients?

Answer: Naughton Protocol

The Naughton Protocol uses small approximately 1-MET workload increments with 2-minute stages, making it the most appropriate choice for elderly or severely deconditioned patients who cannot tolerate the larger increments of the standard Bruce Protocol.

What is the expected normal systolic blood pressure response during progressive treadmill exercise testing?

Answer: Increases progressively, typically by approximately 10 mmHg per MET

Normal systolic BP rises progressively during exercise (approximately 10 mmHg per MET) as cardiac output increases, while diastolic BP typically remains stable or decreases slightly.

Exercise-induced ST elevation in leads WITHOUT pathological Q waves most likely indicates which condition?

Answer: Severe transmural ischemia or coronary artery spasm

ST elevation in leads without Q waves during exercise indicates severe transmural ischemia or coronary vasospasm (Prinzmetal's angina), distinguishing it from reciprocal changes seen in leads with prior infarction Q waves.

What is the primary advantage of cardiopulmonary exercise testing (CPET) over conventional graded exercise testing (GXT)?

Answer: CPET provides direct measurement of VO2, ventilatory threshold, and respiratory gas exchange ratios

CPET adds breath-by-breath gas analysis to standard exercise testing, enabling direct measurement of VO2, VCO2, ventilatory threshold, and RER for more precise functional capacity assessment and risk stratification.

A 6-Minute Walk Test (6MWT) distance below what threshold is associated with poor prognosis in heart failure patients?

Answer: 300 meters

A 6MWT distance below 300 meters in heart failure patients is associated with significantly increased morbidity and mortality, indicating severely impaired functional capacity.

Which medication class most significantly blunts the heart rate response during exercise testing and requires adjustment of target heart rate calculations?

Answer: Beta-blockers

Beta-blockers blunt the heart rate response to exercise by blocking catecholamine-mediated sympathetic stimulation at the SA node, requiring adjusted target heart rate calculations using RPE or metabolic equivalents instead.

In cardiac rehabilitation, a heart rate recovery (HRR) of less than 12 bpm at 1 minute post-exercise is interpreted as which of the following?

Answer: Abnormal autonomic function associated with increased cardiovascular mortality risk

An HRR of less than 12 bpm at 1 minute post-exercise indicates impaired parasympathetic reactivation and is independently associated with increased risk of all-cause and cardiovascular mortality.