The “cornerstone” of modern stress testing was the recognition of the importance of Stress Testing segment changes to predict the presence of Coronary Artery Disease (CAD) in 1918.
Acute MI, high risk of unstable angina, uncontrolled cardiac arrhythmias, symptomatic severe aortic stenosis, pulmonaryinfarction, acute myocarditis, and acute aortic dissection are contraindications for exercise stress testing.
Pre-test preparation for exercise stress testing includes asking about family history and general medical history, making note of any considerations that may increase the risk of sudden death, and avoiding unusual physical exertion before testing.
Safety precautions and equipment for exercise stress testing include a treadmill with front and side rails for subjects to steady themselves, an emergency stop button, and a brief physical examination prior to testing to rule out significant outflow obstruction.
In general, 6 to 12 minutes of continuous progressive exercise during which the myocardial oxygen demand is elevated to the patient’s maximal level is optimal for diagnostic and prognostic purposes.
Treadmill test usually involves walking on a treadmill at increasing levels of difficulty, while electrocardiogram, heart rate, and blood pressure are monitored.