Stress Testing Procedures Flashcards

When applying electrodes for a stress ECG, which skin preparation step is most important for reducing artifact?

Answer: Lightly abrading the skin with fine sandpaper or prep pad

Light abrasion of the skin removes the outer dead cell layer, significantly lowering skin impedance and reducing motion artifact.

What does a horizontal or downsloping ST depression of ≥1mm at 80ms after the J-point during stress testing indicate?

Answer: Myocardial ischemia

Horizontal or downsloping ST depression ≥1mm measured 80ms after the J-point is the classic ECG sign of exercise-induced myocardial ischemia.

Which of the following is a contraindication to performing an exercise stress test?

Answer: Recent acute MI within the past 2 days

Acute MI within the past 2 days is an absolute contraindication because exercise can extend the infarct and precipitate fatal arrhythmias.

During a stress test, a patient develops symptomatic second-degree Mobitz II AV block. The correct action is:

Answer: Immediately terminate the test

New second-degree Mobitz II or third-degree AV block during exercise is an absolute indication for immediate test termination.

The maximum predicted heart rate (MPHR) for stress testing is calculated as:

Answer: 220 minus age

The standard formula for MPHR is 220 minus the patient's age in years, and 85% of this value defines an adequate submaximal effort.

Which lead combination provides the highest sensitivity for detecting ischemia during exercise stress testing?

Answer: V4, V5, and V6 combined with II

Using leads V4, V5, V6, and II together provides the highest sensitivity for detecting lateral and inferior wall ischemia during stress testing.

What is the primary purpose of performing a cool-down walk rather than an abrupt stop at the end of treadmill exercise?

Answer: To prevent venous pooling and hypotension

A cool-down walk prevents sudden venous pooling in the legs that can cause post-exercise hypotension and syncope.