Exercise Stress Test Results Analysis

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Questions and Answers

What was the peak heart rate of the individual during the treadmill exercise test?

  • 140 beats/minute
  • 160 beats/minute
  • 150 beats/minute
  • 152 beats/minute (correct)

Which statement accurately reflects the individual's systolic blood pressure response during recovery?

  • It increased to above pre-exercise levels.
  • It remained unchanged from pre-exercise levels.
  • It fluctuated significantly during recovery.
  • It decreased to below pre-exercise levels. (correct)

What does the absence of ischemic changes on the ECG during or after exercise indicate?

  • A cardiac event is highly probable.
  • A severe exercise-induced myocardial event has occurred.
  • Significant coronary artery disease is present.
  • Coronary artery disease is unlikely. (correct)

How was the change in diastolic blood pressure during exercise characterized?

<p>It declined by 5 mm Hg. (A)</p> Signup and view all the answers

What is indicated by the peak systolic blood pressure during exercise in this scenario?

<p>It exceeds normal values. (A)</p> Signup and view all the answers

Which statement is true regarding the individual's exercise test results?

<p>His peak systolic blood pressure during exercise exceeds that normally observed. (B)</p> Signup and view all the answers

What does the reduction in systolic blood pressure after exercise suggest?

<p>It is typical for individuals with normal exercise capacity. (D)</p> Signup and view all the answers

Which of the following implications can be drawn from the absence of ischemic changes on the ECG?

<p>The individual has normal coronary artery function. (C)</p> Signup and view all the answers

What is implied by the decline in diastolic blood pressure during exercise?

<p>It suggests a normal physiological response to exercise. (C)</p> Signup and view all the answers

What conclusion can be drawn about the individual's exercise capacity?

<p>The test reveals he has a low prognostic risk for coronary events. (B)</p> Signup and view all the answers

Flashcards

Peak Systolic Blood Pressure

The patient's peak systolic blood pressure during exercise was 200 mmHg, which is higher than the normal expected range.

Diastolic Blood Pressure During Exercise

A decrease in diastolic blood pressure during exercise is a normal physiological response, not necessarily an indication of coronary artery disease.

Peak Heart Rate

The standard Bruce protocol aims for achieving a peak heart rate of 85% of the predicted maximum heart rate for the patient's age, but the patient reached 152 beats/minute, enough to be a diagnostic test.

ECG Findings

The patient's lack of ischemic changes on ECG during and after exercise suggests a low risk of coronary artery disease.

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Prognostic Risk

Despite his health history of hypertension and hypercholesterolemia, the patient's exercise test results, including his peak heart rate, blood pressure response, and lack of ischemic changes, are consistent with a low risk of future cardiac events.

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Diastolic Blood Pressure Change During Exercise?

A decline in diastolic blood pressure during exercise is typically expected and not necessarily indicative of coronary artery disease (CAD).

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Elevated Peak Systolic Blood Pressure

The patient's peak systolic blood pressure was 200 mmHg, higher than usually observed during exercise, but needs further evaluation to determine if it's truly abnormal.

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Adequate Peak Heart Rate Achieved?

The patient achieved a peak heart rate of 152 beats/minute, which is sufficient for a diagnostic exercise test regardless of the specific target heart rate.

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ECG Findings During Exercise Test

The lack of ischemic changes on the ECG during and after exercise suggests a low risk of coronary artery disease.

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Prognostic Risk: Low

Considering the patient's medical history and the exercise test findings, the overall risk of a future heart event appears low.

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Study Notes

Exercise Stress Test Results Analysis

  • 54-year-old African-American male with hypertension and hypercholesterolemia underwent a treadmill exercise stress test using the standard Bruce protocol.
  • Test stopped at 11 minutes and 14 seconds due to fatigue.
  • Peak heart rate reached 152 beats/minute.
  • Peak systolic blood pressure was 200 mmHg.
  • Diastolic blood pressure decreased by 5 mmHg during exercise.
  • Post-exercise, systolic blood pressure decreased to 150 mmHg, below pre-exercise levels.
  • No ischemic changes were observed on the ECG during or after exercise.

Interpretation of Results

  • High peak systolic reading during exercise suggests potential pre-existing blood pressure issues.
  • A decrease in diastolic blood pressure during exercise isn't necessarily indicative of coronary artery disease.
  • The test's stopping point, not reaching a high enough peak heart rate for a conclusive diagnosis and presence of fatigue possibly indicates an incomplete evaluation, a nondiagnostic test.
  • The post-exercise drop in systolic blood pressure, combined with no ECG changes, could suggest a lower risk of a future coronary event.
  • An inadequate peak heart rate (not reaching a high enough heart rate target as expected for the protocol) and fatigue are key factors suggesting a nondiagnostic test.

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