Hamish has remained pain free since admission. His cardiac markers were normal and his systemic observations were stable. Hamish has been referred to the cardiac nurse specialist for further assessment to establish a diagnosis and stratify his risks.
During his Exercise Tolerance Test Hamish experiences chest pain and the test is stopped. During a 5-minute recovery period where Hamish continues to be monitored, his chest pain resolves and he then returns to the ward. See additional information for indications for terminating the ETT test.
- ETT: Roll over picture with text appearing
- BP: blood pressure should rise during exercise. A drop of more than 10-20mmHg in systolic BP may imply prognostically significant disease.
- ECG Monitor: ST depression during the test of more than 2mm is considered diagnostic for coronary heart disease. Occasionally patients may develop ST Elevation or rhythm disturbances which often indicates more severe disease.
- Clock: Symptoms of chest pain or ECG changes early in the ETT are more likely to be seen in patients with severe disease.
- Hamish with chest pain: The development of chest pain during exercise is typical of angina and helps establish the diagnosis even if there are no there abnormalities on the ETT.
Pulse point
Cardiac stress tests such as ETTs give both diagnostic and prognostic information for patients with ischaemic heart disease. Stress tests include ETTs, myocardial perfusion scans and stress echo cardiography. In addition to stress tests non-invasive anatomical tests such as CT coronary angiography can also be used. The particular test chosen depends upon many patient factors and availability of tests in local units. (Further information available in Modules 1 and 3).
Page last reviewed: 08 Jun 2020
