Mary developed pain on the treadmill and her ECG showed abnormal changes. The test was stopped due to these changes:
The result of Mary’s test was positive. She had a normal HR and BP response however the significant change was the ST segment depression on her ECG with associated chest pain in stage 2 of the Bruce protocol at 4 and a half minutes. This demonstrates inducible ischaemia (reduced blood flow through one of the coronary arteries during exercise).
Q. What are other indications for stopping an ETT (True and false)
- Drop in systolic blood pressure (SBP) of more than 10 mm (True): this can mean that the ETT is positive as this is an abnormal cardiac response to exertion
- Moderate-to-severe angina symptom (True): this is a symptomatic episode that requires ETT to stop and results of test recorded
- Dizziness (True): any signs of syncope can relate to fall in blood pressure and a positive test
- Feeling faint (True): any signs of near syncope can relate to a fall in blood pressure and a positive test
- Getting bored (False): patient should be encouraged to keep going unless symptomatic or asks to stop
- Signs of peripheral or central cyanosis (True): this is a sign of reduced perfusion
- Subjects desire to stop (True): if patient asked to stop then the test requires to be terminated
- Reddening of patients face and slightly sweaty (False): dont stop-these are normal changes when exercising
- Sustained ventricular tachycardia (True): this is potentially medical emergency and patient should immediately be taken to lie down in room and observations taken as Dr called
- ST elevation (> 1 mm) in leads (True): this is an indication of myocardial strain
- Patient is hungry (False): patient should have had a light meal prior to commencing and can be advised to eat after the test is complete
- Patient is not able to run (False): ETT will be a standard walking speed (see Bruce Protocol) and patient should only stop when test complete or for a valid indicator to stop
Page last reviewed: 03 Jun 2020
