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    Treadmill Test: Khairul Nizam Abdul Rahman 4262143008

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    Dea Amelia Yolanda
    A treadmill test monitors the heart's response to exertion by having a patient walk on a treadmill at increasing difficulty levels while electrocardiogram, heart rate, and blood pressure are recorded. It is used to evaluate heart function and blood flow, check for coronary artery disease, and determine safety of exercise. The test follows a standardized protocol like the Bruce protocol that gradually increases speed and incline over stages up to 21 minutes. Endpoints include symptoms like chest pain or changes in vital signs.

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    Treadmill Test: Khairul Nizam Abdul Rahman 4262143008

    Uploaded by

    Dea Amelia Yolanda
    201 views12 pages
    A treadmill test monitors the heart's response to exertion by having a patient walk on a treadmill at increasing difficulty levels while electrocardiogram, heart rate, and blood pressure are recorded. It is used to evaluate heart function and blood flow, check for coronary artery disease, and determine safety of exercise. The test follows a standardized protocol like the Bruce protocol that gradually increases speed and incline over stages up to 21 minutes. Endpoints include symptoms like chest pain or changes in vital signs.

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    A treadmill test monitors the heart's response to exertion by having a patient walk on a treadmill at increasing difficulty levels while electrocardiogram, heart rate, and blood pressure are recorded. It is used to evaluate heart function and blood flow, check for coronary artery disease, and determine safety of exercise. The test follows a standardized protocol like the Bruce protocol that gradually increases speed and incline over stages up to 21 minutes. Endpoints include symptoms like chest pain or changes in vital signs.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    201 views12 pages

    Treadmill Test: Khairul Nizam Abdul Rahman 4262143008

    Uploaded by

    Dea Amelia Yolanda
    A treadmill test monitors the heart's response to exertion by having a patient walk on a treadmill at increasing difficulty levels while electrocardiogram, heart rate, and blood pressure are recorded. It is used to evaluate heart function and blood flow, check for coronary artery disease, and determine safety of exercise. The test follows a standardized protocol like the Bruce protocol that gradually increases speed and incline over stages up to 21 minutes. Endpoints include symptoms like chest pain or changes in vital signs.

    Copyright:

    © All Rights Reserved
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    Treadmill Test

    Khairul Nizam Abdul Rahman


    4262143008
    What is Treadmill Test?
    • Treadmill test is also called a stress test, exercise
    electrocardiogram, graded exercise test, or stress ECG.
    It is used to provide information about how the heart
    responds to exertion. It usually involves walking on a
    treadmill at increasing levels of difficulty, while
    electrocardiogram, heart rate, and blood pressure are
    monitored.
    Why Need Treadmill Test?
    Treadmill test is use to
    • Determine if there is adequate blood flow to heart during
    increasing levels of activity.
    • Evaluate the effectiveness of heart medications to control angina
    and ischemia.
    • Determine the likelihood of having coronary heart disease and the
    need for further evaluation.
    • Check the effectiveness of procedures done to improve blood flow
    within the heart vessels in people with coronary heart disease.
    • Identify abnormal heart rhythms.
    • Help to develop a safe exercise program.
    Contraindication
    • Acute myocardial infarction (within 2 days)
    • High-risk unstable angina
    • Symptomatic severe aortic stenosis
    • Symptomatic heart failure
    • Acute pulmonary embolus or pulmonary infarction
    • Acute myocarditis or pericarditis
    • Acute aortic dissection
    • Electrolyte abnormalities
    • Tachy or Brady arrhythmias
    • Mental or physical impairment
    • Hypertension (>200/100 at rest)
    • Neuromuscular and musculoskeletal disorder exacerbated by exercise
     block
    Technique
    1. Patients should be instructed not to drink, eat caffeinated
    beverages or smoke 3hour before testing & to wear
    comfortable shoes and clothes.
    2. Unusual physical exertion should be avoided
    3. Brief history & physical examination should be performed
    4. Should be instructed about risks and benefits
    5. Informed consent is taken
    6. 12 lead ECG is recorded with electrodes at the distal
    extremities
    7. Torso ECG is obtained in standing and sitting position
    8. If false +ve test is suspected, hyperventilation should be
    performed
    Technique
    9. Area of electrode application should be rubbed with
    alcohol saturated pad to remove oil and rubbed with sand
    paper to reduce skin resistance to 5000ohms or less
    10. Cables should be light flexible and shielded
    11. Room temperature should be 18-24 C and humidity less
    than 60%
    12. Walking should be demonstrated to patient
    13. HR, BP & ECG should be recorded at the end of each
    stage.
    14. Minimum of 3 leads should be displayed continuously on
    the monitor
    15. A resuscitator cart, defibrillator and appropriate
    cardioactive drugs should be available in the TMT room.
    When To Stop!?
    TMT might be prematurely stopped for any of the following:
    • Moderate to severe angina
    • Increasing chest pain
    • Increasing nervous system symptoms (ataxia, dizziness)
    • Signs of poor perfusion (cyanosis or pallor)
    • Sustained ventricular tachycardia
    • ST elevation (≥1.0 mm)
    • ST depression (>2 mm)
    • Drop in SBP of (≥10 mmHg) BP without ischemia
    • Heart block or brady arrhythmias
    • Technical difficulties in monitoring ECG or SBP
    • Fatigue, shortness of breath, wheezing, leg cramps
    Bruce Protocol
    • Total of 1+6 (Seven 3 minute stages) – (3+18 min)
    • Each minute exercise is approximately 1 MET
    • Pretest plain walking + 6 Stages of graded
    exercise
    • In each stage there is increase in speed and
    gradient
    • Initial 1.7 mph with 10% gradient (upward
    inclination)
    • Maximum 5.5 mph with 20% gradient
    Bruce Protocol
    Stage Minutes % grade km/h MPH METS
    1 3 10 2.7 1.7 5
    2 6 12 4.0 2.5 7
    3 9 14 5.4 3.4 10
    4 12 16 6.7 4.2 13
    5 15 18 8.0 5.0 15
    6 18 20 8.8 5.5 18
    7 21 22 9.6 6.0 20
    What is MET?
    • Metabolic Equivalent Term
    • 1 MET = 3.5 ml O2 per kilogram of body weight
    per minute
    • Actually differs with thyroid status, post exercise,
    obesity, disease states
    • By convention just divide ml O2/Kg/min by 3.5
    METs = Speed x [0.1 + (Grade x 1.8)] + 3.5
    3.5
    • Calculated automatically by Device
    Karvonen Method
    • The Karvonen method factors in resting heart
    rate (HRrest) to calculate target heart rate (THR),
    using a range of 50–85%:

    • THR = ((HRmax − HRrest) × %Intensity) + HRrest


    • Example for someone with a HRmax of 180 and a
    HRrest of 70:
    • 50% intensity: ((180 − 70) × 0.50) + 70 = 125 bpm
    • 85% intensity: ((180 − 70) × 0.85) + 70 = 163 bpm

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