Exercise Stress Testing Flashcards
6 cards from real CCT practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Exercise Stress Testing flashcards as text
What is the most important absolute contraindication to exercise stress testing?
Answer: Acute myocardial infarction within the previous 2 days
Acute myocardial infarction within 2 days is an absolute contraindication because exercise increases myocardial oxygen demand and can extend the area of infarction or precipitate ventricular arrhythmias in the setting of acute ischemia.
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?
Answer: The test is diagnostic — the patient achieved target heart rate without evidence of ischemia
Achieving 85% or more of the age-predicted maximum heart rate (APMHR) without developing symptoms or significant ECG changes constitutes an adequate and negative stress test, providing diagnostic certainty.
A patient develops 3 mm of horizontal ST depression in lead V5 at peak exercise. What does this finding indicate?
Answer: A positive stress test result suggesting myocardial ischemia
Horizontal or downsloping ST depression of 1 mm or more (measured 60-80 ms after the J point) is the diagnostic criterion for a positive stress test indicating myocardial ischemia. 3 mm is a strongly positive finding.
Which finding during exercise stress testing is an indication for immediate test termination?
Answer: A drop in systolic blood pressure of more than 10 mmHg below resting baseline despite increasing workload
A drop in systolic blood pressure of more than 10 mmHg below the pre-exercise resting level during increasing workload (exertional hypotension) is an absolute indication for test termination because it suggests severe left ventricular dysfunction or outflow obstruction.
What is the purpose of the recovery phase after a stress test?
Answer: To monitor for delayed ECG changes and hemodynamic recovery, and ensure patient safety
The recovery phase is a critical monitoring period where delayed ST changes or arrhythmias may appear, and where hemodynamic parameters (heart rate, blood pressure) return to baseline, confirming the patient is stable to leave.
A 55-year-old patient cannot exercise on a treadmill due to severe arthritis. What is the most appropriate alternative to exercise stress testing?
Answer: Pharmacologic stress testing with vasodilators (adenosine/regadenoson) or dobutamine combined with imaging
Pharmacologic stress testing using vasodilators (adenosine, dipyridamole, regadenoson) or inotropic agents (dobutamine) combined with nuclear imaging or echocardiography is the established alternative for patients unable to exercise.