What is a Stress ECG? The Stress ECG is a sophisticated cardiac investigation that takes approximately 30
minutes to perform. The patient is attached to multiple ECG electrodes and is then asked
to walk on treadmil - with increasing degrees of effort and gradient over roughly 20
The stress ECG is predominantly used to detect coronary narrowing that could explain
symptoms on effort- or compromise your future- since coronary narrowing can lead to
The test is also a good guide to cardiovascular fitness, and your natural heart rate and
What are the common uses of the procedure? A Stress ECG can be used in the evaluation of a variety of complaints and conditions.
It may help in the evaluation of chest pain and breathlessness
It may help to identify unsuspected heart problems such as cardiomyopathy and coronary heart disease
It may reveal serious and potentially life threatening disorders such as critical coronary narrowing
How should I prepare for the examination? The Stress ECG is best done after avoiding all stimulants and drugs that affect the heart rate- including Coffee, Tea and Beta blockers. Please check your prescription and do NOT take betablocker medication such as Atenolol, Bisoprolol, Propranolol, Carvidolol or Ivabradine.
Because of the need to exercise, comfortable clothing and gym shoes should be worn, and a towel brought along in case of excessive sweating. Avoid applying skin creams and oils to your skin on the day of the test since these will reduce electrical conductivity and may hamper the signal. What will I experience during the examination The Nurse or Technician will invite you into the Exercise test room, where you will need to strip to the waist, and while 10 electrodes connected across the chest and trunk. Your details will then be entered onto the computer and a recording taken. You may be shown how the treadmill works, and how to move onto it in preparation for the test. The tracing is then analysed by an experienced Cardiologist who will also be informed about whether you have any symptoms or are taking any medication. Are there risks involved? A stress ECG carries a small risk of collapse and heart attack. This is why the test must be carried out in a cardiac centre where full resuscitation equipment and emergency drugs are available. There needs to be a full compliment of trained staff, including a Cardiologist available within seconds. Most people take the view that if you have a heart condition that puts you at risk of exercise induced collapse, its better to be first detected and treated in a Cardiac Centre and thus the small risk of the test is easily balanced by its benefits. How will I get the results Although the Stress ECG will be available minutes after the test, its main value is how this is interpreted by the Cardiologist in context. For example small changes in the ST segment at stage one of the test may be terrifically important if there is a family history of collapse or sudden death or if the blood pressure is raised, so the true power of the investigation can only be realized when interpreted by an experienced Cardiologist who has been made aware of your history, any medical conditions, medication and whether you have symptoms. Once these data are collected and presented to the Cardiologist, a report will be issued - and sent to your GP. If you have requested it, a copy can also be sent to you electronically, so that you or your physician can view it any time in the future.
Please note that an exercise test is useful for detecting coronary artery narrowing, but not coronary plaque, so for a complete coronary risk assessment a should be considered. consists of a Nurse questionnaire, a 12 lead , a stress ECG and a Cardiologist report- all of which will be sent to the patient within 7 working days of the stress ECG- since this heart screen can be requested without a GP referral
Department of Population and International Health ISSUES IN HEALTH AND HUMAN RIGHTS Syllabus Professor Stephen P. Marks. Tel. 432-4316, email: smarks@hsph.harvard.edu Room 1202B, HSPH Building I, Tues. 4:00 – 6:00 p.m. and by appointment Contents: Introduction Schedule of sessions Overview of course structure, objectives and methods The content and process of internationa
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