| Update on exercise stress testing. | |
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MedLine Citation:
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PMID: 17137006 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Exercise stress testing is an important diagnostic tool for the evaluation of suspected or known cardiac disease. In 2002, the American College of Cardiology (ACC) and the American Heart Association (AHA) revised their guidelines for exercise testing. Ten categories from the ACC/ AHA 1997 guidelines were modified: ST heart rate adjustment, unstable angina, older patients, acute coronary syndromes, chest pain centers, acute myocardial infarction, asymptomatic patients, valvular heart disease, rhythm disturbances, and hypertension. Adjustment of the ST heart rate can identify myocardial ischemia in asymptomatic patients with elevated cardiac risk. Intermediate- and low-risk patients with unstable angina, acute coronary syndromes, or chest pain should undergo exercise stress testing when clinically stable. Provided they are stable, patients who have had acute myocardial infarction can undergo a submaximal exercise test before discharge or a symptom-limited exercise stress test any time after two to three weeks have elapsed. In asymptomatic patients with cardiac risk factors, the exercise stress test may provide valuable prognostic information. Aortic regurgitation is the only valvular heart disorder in which there is significant evidence that exercise stress testing is useful in management decisions. The stress test also can be used in older patients to identify the presence of coronary artery disease. However, because of other comorbidities, a pharmacologic stress test may be necessary. Exercise stress testing can help physicians successfully evaluate arrhythmia in patients with syncope. The exercise stress test also can help identify patients at risk of developing hypertension if they show an abnormal hypertensive response to exercise. |
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Authors:
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Gerald F Fletcher; Wesley C Mills; Walter C Taylor |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: American family physician Volume: 74 ISSN: 0002-838X ISO Abbreviation: Am Fam Physician Publication Date: 2006 Nov |
Date Detail:
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Created Date: 2006-12-01 Completed Date: 2006-12-18 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 1272646 Medline TA: Am Fam Physician Country: United States |
Other Details:
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Languages: eng Pagination: 1749-54 Citation Subset: AIM; IM |
Affiliation:
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Mayo Clinic, Jacksonville, Florida 32224, USA. fletcher.gerald@mayo.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Age Factors Exercise Test* Heart Diseases / diagnosis* Humans Hypertension / diagnosis Practice Guidelines as Topic Risk |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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