Guidelines
for stress testingInvestigations
- Check FBC/U&E (and lipids)
Guidelines for an exercise test
- Diagnosis of coronary ischaemia
- Anginal pains - seeking objective proof
- Exertional SOB - ?ischaemic in origin
- Assessment of known coronary disease
- Patients with inadequate medical control.
- Patients not well controlled on two regular anti-ischaemic agents.
- Patients with residual angina on 3-4 regular agents.
- Patients with previous revasacularisation - refer.
- Patients with complications - refer.
- 6 weeks post MI
Checklist - ECG exclusions
- Left bundle branch block
- LV hypertrophy with ST-T change
- WPW syndrome
- Unexpected acute MI/ischaemia
Checklist - contraindications
- On digoxin
- Aortic stenosis
- Other severe valve stenosis
- Hypertrophic cardiomyopathy
- Severe heart failure
- Unstable angina
- Uncontrolled hypertension (>200/100)
- Unstable cardiac rhythm (AFis OK off digoxin if rate <120)
- Myocarditis or pericarditis
- Intercurrent illness/pneumonia
- Limiting Arthritis/COAD/claudication
Results of open access stress tests