Today our topic of discussion is Procedure of Stress Testing.

Procedure of Stress Testing

Procedure

Stress testing requires the use of a bicycle ergometer or a treadmill with continuous electrocardiac recording
The test is performed in a series of stages in which the client exercise for 3 minutes. Verities of protocols are used in stress testing
The Bruce protocol involves gradual increase in speed and intervals of short duration .
At the end of each stage, a 12 lead ECG is recorded.
After each stage, the work load or graded load is increased
This is accomplished by increasing the speed or resistance of the bicycle or treadmill
The stress testing continues until the client reaches 85% of the maximum heart rate, becomes symptomatic or displays electrocardiography changes consistent with ischemia.

The maximum heart rate is usually determined by normograms.
A gross estimate of the maximum heart rate is 220 beats per minute minus the client’s age If a client is physically unable to exercise to the point of 85% of the maximum heart rate, a dipyridamole (persantine) scan may be performed
Dipyridamole may be given intravenously or by mouth. It causes coronary artery dilatation similar to the response of the coronary arteries to exercise
As the graded exercise begins, a multichanneled ECG is recorded.
A 12 lead ECG is recorded and the blood pressure is checked as each workload ends (every 3 minute increment)
Observe foe signs to stop the stress testing, for example, falling blood pressure, three consecutive premature ventricular contractions, chest pain or exhaustion.

Findings

A 1 mm depression of the ST segment is positive stress test, indicating myocardial ischemia.

After Care

Cardiac monitoring is continued for 5-10 minutes after the testing to evaluate the client’s physiologic responses.
Blood pressure is checked
Remove conduction jelly and assist in robbing the client if necessary
Evaluate the client’s physical and emotional response to testing
Instruct the client to rest and not to take hot shower or baths for 2-4 hours.

Contraindications

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