Exercise Treadmill Testing

Exercise Treadmill Testing Part I ,[object Object],[object Object],[object Object]

ETT Workshop Format ,[object Object],[object Object],[object Object],[object Object],[object Object]

OBJECTIVES ,[object Object],[object Object],[object Object],[object Object]

ETT by Family Physicians ? ,[object Object],Goeschel DP et al, J Fam Pract 1994; 38:132

ETT by Family Physicians ? ,[object Object],Jurica,JW et al. Graded Exercise Stress Testing in Family Practice and Internal Medicine Residencies . J Fam Pract 1989; 29: 537-41

Why ETT? ,[object Object],[object Object]

Why ETT by Family Physicians? ,[object Object],[object Object],[object Object],[object Object]

Reasons cited by FPs not performing ETT: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],J Fam Pract 1994 ; 38 (2) : 135

Conclusion ,[object Object],Goeschel, DP et al. Geographic Variation in Exercise Testing by Family Physicians. J Fam Pract 1994; 38 (2):132-137

Feasibility ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Clinical Competence in ETT: ACP / ACC / AHA Task Force, 1990 ,[object Object]

Maintenance of Competence: ACP / ACC / AHA Task Force, 1990 ,[object Object]

ACC / AHA Task Force, 1997 ,[object Object]

Treadmill Systems Evaluated Spacelabs / Burdick Quest Stress System ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Treadmill Systems ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

ETT System Layout Treadmill BP Cuff Recorder Monitor Controller Crash Cart

Treadmill System ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Patient Selection Criteria ,[object Object]

Chest Pain... ,[object Object],[object Object],[object Object]

Risk Factors: Coronary Artery Disease ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Other Indications for ETT... ,[object Object],[object Object],[object Object]

Patient Selection Criteria Indications for Office-Based Graded Exercise Testing: Screening for ischemic heart disease in asymptomatic individuals (especially those with multiple cardiac risk factors) Evaluation of (atypical) chest pain Determining exercise capacity; and giving an exercise prescription.

Patient Selection Criteria ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Patient Selection Criteria ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Before the ETT... ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Informed Consent ,[object Object],[object Object],[object Object],[object Object]

Complications of ETT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Five Year Experience: ETT in a FP Residency, Scottsdale Arizona ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Fam Med 1994; 26:290-292

How long? How fast? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Which ETT Protocol ? ,[object Object],[object Object],[object Object],[object Object],[object Object]

ETT Tracing... ,[object Object],[object Object],[object Object]

Patterns indicative of ischemia...

Exercise induced ST Depression ... ,[object Object],[object Object]

Patterns not indicative of ischemia...

Sign/Symptom Testing Endpoints ,[object Object],[object Object],[object Object],[object Object],[object Object]

Relative Indications for terminating the ETT... ,[object Object],[object Object],[object Object],[object Object],[object Object]

Absolutely terminate the test when... ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Possible causes of False Positive ETT for CAD: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Options for evaluating ischemia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Echocardiography ,[object Object],[object Object],[object Object],[object Object]

Testing options... ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

When is a Thallium ETT needed? ,[object Object],[object Object],[object Object],[object Object],[object Object]

Sensitivity / Specificity ,[object Object],[object Object],[object Object],[object Object]

Sensitivity / Specificity ( $ 250) ($ 1300 +) ($ 3000+)

Clinical Case 1 ,[object Object],[object Object],[object Object]

Clinical Case 4 ,[object Object],[object Object]

Clinical Case 5 ,[object Object],[object Object]

Caveats on ETT... ,[object Object],[object Object],[object Object],[object Object]

Referral from clinical sites ,[object Object],[object Object],[object Object],[object Object],[object Object]

Exercise Treadmill Testing

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Exercise Treadmill Testing