CCT Exercise Stress Testing 2

Question 1

What is the most important absolute contraindication to exercise stress testing?

Accepted Answer

Acute myocardial infarction within the previous 2 days

Answer

Controlled hypertension with resting BP of 150/90

Answer

Mild aortic stenosis

Answer

History of stable angina

Question 2

During the Bruce protocol, a patient achieves 85% of their age-predicted maximum heart rate without symptoms or ECG changes. How is this test best interpreted?

Accepted Answer

The test is diagnostic — the patient achieved target heart rate without evidence of ischemia

Answer

The test is non-diagnostic because the patient did not develop symptoms

Answer

The test should be repeated immediately at a higher workload

Answer

The test is positive for ischemia because of the high heart rate achieved

Question 3

A patient develops 3 mm of horizontal ST depression in lead V5 at peak exercise. What does this finding indicate?

Accepted Answer

A positive stress test result suggesting myocardial ischemia

Answer

A normal physiologic response to exercise

Answer

Artifact caused by lead movement during exercise

Answer

Pericarditis unmasked by exercise

Question 4

Which finding during exercise stress testing is an indication for immediate test termination?

Accepted Answer

A drop in systolic blood pressure of more than 10 mmHg below resting baseline despite increasing workload

Answer

A normal increase in heart rate from 70 to 120 bpm

Answer

Mild dyspnea that the patient tolerates

Answer

Sinus tachycardia at peak exercise

Question 5

What is the purpose of the recovery phase after a stress test?

Accepted Answer

To monitor for delayed ECG changes and hemodynamic recovery, and ensure patient safety

Answer

To rest the patient before they leave

Answer

To re-establish electrode contact that was lost during exercise

Answer

To recalibrate the ECG machine

Question 6

A 55-year-old patient cannot exercise on a treadmill due to severe arthritis. What is the most appropriate alternative to exercise stress testing?

Accepted Answer

Pharmacologic stress testing with vasodilators (adenosine/regadenoson) or dobutamine combined with imaging

Answer

No stress testing should be performed since exercise is not possible

Answer

Rest ECG alone to evaluate for ischemia

Answer

The patient should be referred directly for coronary angiography without stress testing