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Exercise Testing

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Essential Cardiology

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Abstract

Exercise testing is an important part of the clinical evaluation of cardiovascular status. In this chapter, we will review the different protocols, indications, and contraindications for this testing. The diagnostic, as well as prognostic, use of exercise testing are explained, with reference to the current ACC/AHA guidelines. The two major exercise test scores—the Duke treadmill and VA predictive score—each provide important prognostication tools for patient care. The chapter includes how to calculate each score and provides an example of using the Duke nomogram with the important variable of age added. The exercise stress test is also compared to other methods of stress testing, such as nuclear perfusion and echocardiogram examinations. Patient characteristics such as beta-blocker use, digoxin use, gender, age, and symptoms require consideration, but do not preclude exercise stress testing. The exercise test is relatively inexpensive, noninvasive, and readily available. It provides both diagnostic and prognostic information and can also help determine functional capacity and degree of disability.

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Notes

  1. 1.

    Pretest probability was determined from the Diamond-Forrester estimates by age, symptoms, and gender (see Table 9.4).

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Recommended Reading

  • Ashley EA, Forlicher V. The post myocardial infarction exercise test: still worthy after all of these years. Eur Heart J. 2001;22:273–6.

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  • Froelicher VF, Myers J. Exercise and the heart. 4th ed. Philadelphia: W.B. Saunders Company; 1999.

    Google Scholar 

  • Gibbons RJ, Balady GJ, Bricker JT, Chaitman BR, Fletcher GF, Froelicher VF, et al. ACC/AHA 2002 guideline update for exercise testing: summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to update the 1997 exercise testing guidelines). Circulation. 2002;106:1883–92.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Stanford University Hospital and Clinics, 300 Pasteur Drive, Standford, CA, 94305, USA

    Abhimanyu (Manu) Uberoi MD, MS & Victor Froelicher MD

  2. Department of Internal Medicine, Stanford University Hospital and Clinics, Stanford, CA, USA

    Shirin Zarafshar MD

Authors
  1. Abhimanyu (Manu) Uberoi MD, MS
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  2. Shirin Zarafshar MD
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  3. Victor Froelicher MD
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Corresponding author

Correspondence to Victor Froelicher MD .

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Editors and Affiliations

  1. The Mount Sinai School of Medicine, The James J. Peters VA Medical Center, Department of Medicine, West Kingsbridge Rd 130, Bronx, 10468, New York, USA

    Clive Rosendorff

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Uberoi, A.(., Zarafshar, S., Froelicher, V. (2013). Exercise Testing. In: Rosendorff, C. (eds) Essential Cardiology. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6705-2_9

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  • DOI: https://doi.org/10.1007/978-1-4614-6705-2_9

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