Exercise Testing Flashcards

Which of the following is an absolute contraindication to exercise stress testing?

Answer: Acute myocardial infarction within the past 2 days

Acute myocardial infarction within the past 2 days is an absolute contraindication to exercise stress testing per ACC/AHA guidelines due to risk of hemodynamic instability and infarct extension.

What systolic blood pressure response during exercise testing indicates an absolute need to terminate the test?

Answer: Drop of 10 mmHg or more from baseline despite increasing workload

A drop in systolic BP of 10 mmHg or more from baseline with increasing workload (exertional hypotension) is an absolute indication for test termination, suggesting severe LV dysfunction or hemodynamic compromise.

In heart failure, a peak VO2 below what threshold indicates severely impaired functional capacity and may prompt transplant evaluation?

Answer: 10 mL/kg/min

A peak VO2 below 10 mL/kg/min indicates severely impaired functional capacity and is one criterion used in heart failure advanced therapy and transplant listing decisions.

The ventilatory (anaerobic) threshold during CPET is best defined as which of the following?

Answer: The exercise intensity at which lactate production exceeds clearance, causing a nonlinear rise in ventilation relative to VO2

The ventilatory threshold is identified by a nonlinear increase in VE relative to VO2 (V-slope method), reflecting the point where lactate production exceeds buffering and clearance capacity.

Chronotropic incompetence is defined as failure to achieve what percentage of the age-predicted maximum heart rate during maximal exercise testing?

Answer: 80%

Chronotropic incompetence is defined as the inability to achieve 80% or more of the age-predicted maximum heart rate during maximal exercise, indicating impaired sympathetic heart rate augmentation.

The Duke Treadmill Score is calculated using which combination of variables?

Answer: Exercise duration, ST deviation, and angina index

Duke Treadmill Score equals exercise time in minutes minus 5 times ST deviation in mm minus 4 times the angina index, stratifying patients into low, intermediate, or high cardiovascular risk categories.

For an exercise stress test to be considered diagnostically adequate, what percentage of the age-predicted maximum heart rate should be achieved?

Answer: 85%

Achieving 85% or more of the age-predicted maximum heart rate (220 minus age) is required for an exercise stress test to be diagnostically adequate, ensuring sufficient myocardial oxygen demand to provoke detectable ischemia.