CARDIAC STRESS TESTS-ETT, ECHO, MPI INDICATIONS

SUMMARY

1. An exercise stress test (ETT, exercise echo, exercise MPI) is always preferred if the patient has no limitations.

2. If the resting ECG is abnormal (with exception of LBBB and paced rhythm), shows WPW syndrome or on digoxin, perform exercise testing with echo or MPI.

3. A pharmacologic stress test is done if the patient cannot do more than moderate exercise, is unable to increase the HR (pacemaker) or has LBBB.

4. Do not use adenosine or dipyridamole in patients with asthma, severe carotid stenosis, VT, uncontrolled HTN, or paced ventricular rhythm.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].