Document Detail


Update on exercise stress testing.
MedLine Citation:
PMID:  17137006     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Gerald F Fletcher; Wesley C Mills; Walter C Taylor
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  American family physician     Volume:  74     ISSN:  0002-838X     ISO Abbreviation:  Am Fam Physician     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-12-01     Completed Date:  2006-12-18     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  1272646     Medline TA:  Am Fam Physician     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1749-54     Citation Subset:  AIM; IM    
Affiliation:
Mayo Clinic, Jacksonville, Florida 32224, USA. fletcher.gerald@mayo.edu
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MeSH Terms
Descriptor/Qualifier:
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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