Throughout history, there are different guidelines set on the topic of exercise testing. Two organizations that handle these changes are the American College of Cardiology (ACC) and the American Heart Association (AHA). These organizations set guidelines for exercise testing in 1997 but then revised these guidelines again in 2002. In 2002, they modified ten categories from the 1997 guidelines. These ten guidelines that were changed include: ST heart rate adjustment, unstable angina, older patients, acute coronary syndromes, chest pain centers, acute myocardial infarction, asymptomatic patients, valvular heart disease, rhythm disturbances and hypertension. What they found with the ST heart rate was that there was a higher risk of a cardiac event was seen with those who were asymptomatic with an abnormal ST Heart rate, verses those who had abnormal stress test results. The guidelines based upon Acute Coronary Syndrome, Acute Myocardial Infraction, and Unstable Angina, was by developing the risk stratification. There are three categories: Low, intermediate and high risk. The guideline changes pertaining to older patients were that they should be subjected to stress
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For instance, if the individual has and injury to the lower extremities, they may not be able to perform the exercise test on the treadmill. However, in order to examine the individual, they will still need to go through an exercise test. Different exercise tests that they could perform could be a bicycle stress test. Along with the cycle ergometers, there are arm ergometers options available for those without use of their legs. If the individual is unable to perform a laboratory exercise, test then a Holter monitor can be used. A Holter monitor is a portable ECG that is worn by the individual for 24-48 hours while they go about their daily activities. The disadvantage to the Holter monitor is that patients have to keep a log of symptoms, activities, meals, medications, stressful situation and time in order for the test to be reliable. This means that the validity of the test relies on the patient to be a good log keeper (Roberts, Robergs, & Hanson …show more content…
The introduction of Thallium201 myocardial imaging along with exercise helped advance the use of radiopharmaceuticals along with exercise testing. The advancement in technology allowed for the progression from ECG exercise testing to the use of Single Photon Emission Computed Tomography (SPECT) and Positron Emission Tomography (PET) to provide improvements in diagnostic efficacy. Pharmacologic testing has grown in its use as most people who are in need of an exercise test typically have a restriction on the amount of physical activity they can perform. This is where the pharmacologic substances such as dobutamine, adenosine, or dipyridamole are used to induce the stress similar to physical activity. Another advancement that technology has provided us with is the use of radiopharmaceuticals; these substances are induced into the cardiovascular system and are able to be traced within the myocardium. The use of a radiotracer was first used in 1964. Over the next couple of years different advancements have discovered better radiotracers. In 1973 Potassium43 was introduced whereas in 1975, Thallium201 was introduced. Thallium201 is still commonly used in nuclear imaging, although new 99mTc-labled tracers (Sestamibi, teboroxime, and tetrofosmin) have all been approved for use by the United Stated Food and Drug Administration. Myocardial perfusion imaging has the advantage over
For instance, if the individual has and injury to the lower extremities, they may not be able to perform the exercise test on the treadmill. However, in order to examine the individual, they will still need to go through an exercise test. Different exercise tests that they could perform could be a bicycle stress test. Along with the cycle ergometers, there are arm ergometers options available for those without use of their legs. If the individual is unable to perform a laboratory exercise, test then a Holter monitor can be used. A Holter monitor is a portable ECG that is worn by the individual for 24-48 hours while they go about their daily activities. The disadvantage to the Holter monitor is that patients have to keep a log of symptoms, activities, meals, medications, stressful situation and time in order for the test to be reliable. This means that the validity of the test relies on the patient to be a good log keeper (Roberts, Robergs, & Hanson …show more content…
The introduction of Thallium201 myocardial imaging along with exercise helped advance the use of radiopharmaceuticals along with exercise testing. The advancement in technology allowed for the progression from ECG exercise testing to the use of Single Photon Emission Computed Tomography (SPECT) and Positron Emission Tomography (PET) to provide improvements in diagnostic efficacy. Pharmacologic testing has grown in its use as most people who are in need of an exercise test typically have a restriction on the amount of physical activity they can perform. This is where the pharmacologic substances such as dobutamine, adenosine, or dipyridamole are used to induce the stress similar to physical activity. Another advancement that technology has provided us with is the use of radiopharmaceuticals; these substances are induced into the cardiovascular system and are able to be traced within the myocardium. The use of a radiotracer was first used in 1964. Over the next couple of years different advancements have discovered better radiotracers. In 1973 Potassium43 was introduced whereas in 1975, Thallium201 was introduced. Thallium201 is still commonly used in nuclear imaging, although new 99mTc-labled tracers (Sestamibi, teboroxime, and tetrofosmin) have all been approved for use by the United Stated Food and Drug Administration. Myocardial perfusion imaging has the advantage over