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Cardiovascular Testing Techniques

Cardiovascular Testing Techniques. Methods of Testing Cardiac Function. Holter Monitors Non-exercise stress testing Dobutamine induced increases in HR Echocardiography Stress Echocardiogram Graded Exercise Testing Nuclear (thallium or technetium) chemical tests Coronary angiography .

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Cardiovascular Testing Techniques

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  1. Cardiovascular Testing Techniques

  2. Methods of Testing Cardiac Function • Holter Monitors • Non-exercise stress testing • Dobutamine induced increases in HR • Echocardiography • Stress Echocardiogram • Graded Exercise Testing • Nuclear (thallium or technetium) chemical tests • Coronary angiography

  3. Relative Contraindications • Severe hypertension • Mild-to- moderate aortic stenosis, • Hypertrophic obstructive cardiomyopathy • Frequent ectopy • Orthopedic limitations • Other conditions that may increase relative risk

  4. Absolute Contraindications • Acute CHF • Acute MI • Active myocarditis • Ongoing unstable angina • Recent embolism • Dissecting aneurysm • Acute illness, • Thrombophlebitis • Moderate-to-severe aortic stenosis • EKG that cannot be interpreted

  5. EKG Contraindications Conditions that preclude reliable ECG interpretation: • Left bundle branch block • Wolff-Parkinson-White • Physiological rate adaptive pacing • Left ventricular hypertrophy with ST segment changes • Extensive anterior wall infarction Exercise testing may still provide useful information on exercise capacity and hemodynamic responses

  6. Left Bundle Branch Block

  7. Wolff-Parkinson-White Syndrome • Electrically active muscle fibers bridge the atria and ventricles and cause pre-excitation of the ventricles. • This accessory pathway is able to conduct faster than the AV node. • WPW is a reentry mechanism with an accessory pathway. • Can be difficult to diagnose in some children because of the higher normal sinus rates and rapid AV node conduction.

  8. Wolff-Parkinson-White Syndrome

  9. LVH with ST segment changes

  10. Pharmacological Impact on CV Response to Exercise • Beta-blockers • peak HR may be 50 to 60% less than predicted max HR • systolic rise of only 20 to 30 mm Hg • Vasodilators • restricted BP increases

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