Who should undergo a simple exercise treadmill test (ETT) without imaging?
Used in conjunction with other clinical data, ETTs are very effective at prognosticating a patient risk of death or non-fatal myocardial infarction. Patients appropriate for this test should be able to exercise safely on a treadmill to reach their goal heart rate [85% x (220 – age)]. Further, it is important to have a normal resting electrocardiogram. The utility of the test is greatly diminished and not recommended with the following conditions: • Left bundle branch block on ECG • Use of Digoxin • Left ventricular hypertrophy • Ventricular paced rhythm • Pre-excitation – WPW • Widespread ST abnormalities My patient cannot exercise. How should they be stressed? Patients who are unable to exercise due to peripheral vascular disease, intrinsic lung disease, poor exercise tolerance, arthritis or other reasons will need to be stressed by pharmacologic means. The two main agents used are dipyridamole (Persantine) and dobutamine. • Persantine is a vasodilating agent generally used with nucle
