Chapter 4
The QRS duration is usually how long?
60-120 ms
Name a RELATIVE CONTRAINDICATION for symptom-limited maximal exercise testing?
Known obstructive left main coronary stenosis, tachyarrhythmias with uncontrolled ventricular rate, complete heart block, recent stroke, BP > 200 or 110
What kind of path of electrical activity in the heart is against electrical activity of ECG lead?
Negative
Considered the pacemaker of the heart. (Full name)
Sinoatrial node (SA node)
What is the most important ECG portion when it comes to the presence of myocardial ischemia?
ST-segment
Name 2 variables that are typically monitored during a graded exercise test?
ECG, blood pressure, symptoms, heart rate, RPE
Name an ABSOLUTE CONTRAINDICATION for symptom-limited maximal exercise testing?
Acute myocardial infarction within 2 d, ongoing unstable angina, active endocarditis, uncontrolled arrhythmia, acute aortic dissection, etc..
What does the P-wave represent?
Atrial depolarization
A congenital abnormality in which an extra electrical pathway in the heart causes a rapid heartbeat.
Wolf-Parkinson-White syndrome
A heart rate that does not increase with an increase in workload could indicate ________.
Chronotropic incompetence
At what interval should blood pressure be monitored during a symptom-limited maximal exercise test?
During the last 30–60 s of each stage
Name a RELATIVE INDICATION for terminating a symptom-limited maximal exercise testing?
ST displacement, drop in SBP without ischemia evidence, increasing chest pain, fatigue, arrhythmias, hypertensive response, bundle branch block, SpO2 <80%
What does the T-wave represent?
Ventricular repolarization
What could be the main cause of cramps according to the latest research?
Overactivation of muscle spindles and inhibition of GTO
What is the rule of 300?
Divide 300 by the number of large boxes between R-R intervals.
At what interval should heart rate be monitored during a symptom-limited maximal exercise test?
Continuously but recorded during the last 5–10 s of each minute
Name an ABSOLUTE INDICATION for terminating a symptom-limited maximal exercise testing?
ST elevation, drop in SBP, severe angina, CNS symptoms, poor perfusion, V tach, technical difficulties, request to stop
What does the QT interval represent?
Time period of complete ventricular activity
Exercise-induced myocardial ischemia may cause left ventricular dysfunction, exercise intolerance, and a ___________ blood pressure response.
Hypotensive
What is sensitivity and specificity?
Sensitivity: the ability to positively identify individuals who truly have IHD
Specificity: the ability to correctly identify individuals who do not have IHD
What is the normal heart rate response to workload increments?
10 bpm per 1 MET
What is the normal blood pressure response to workload increments?
Increase 10 mmHg/min per 1 MET
How much time does a small box represent in a normal ECG run?
0.04 seconds
What is the formula to calculate rate pressure product?
SBP x HR
Name a cause for a false positive symptom-limited maximal test result for the diagnosis of IHD.
ST segment depression >1 mm at rest, LVH, accelerated conduction defects, digitalis therapy, nonischemic cardiomyopathy, hypokalemia, coronary spasm, anemia, observer error, mitral valve prolapse, pericardial disorders, vasoregulatory abnormalities