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Stress Testing: Chapter 19 Worksheet B 1. Arrhythmias for which there should be no debate about stopping the test include ___ _________ __________ or ________ ________ _________ and ventricular tachycardia of any duration. 2. ___________ and ___________are the most common cardiopulmonary symptoms elicited during exercise. 3. Assessment of symptoms and perception of effort during the exercise test are important to _____________ safety. 4. Patients should be encouraged to exercise as long as possible but they should not be pushed beyond their ____________ and any request to stop the test should be ___________. 5. ST segment changes 2 – 4 minutes into recovery are now known to be particularly important for the detection of ____________. 6. An _______ ____________ __________ consists of walking on the treadmill at a speed of 1.5 to 2.0 mph or continuing to pedal the cycle ergometer slowly at a work rate ranging from 0 to 25 W. 7. During recovery period, blood pressure, the electrocardiogram, and symptoms should be monitored and recorded at __ ___________ _____________ for the duration of the recovery period. 8. Patients should be told they may experience fatigue and muscle soreness and to avoid any ___________ ____________ the day of the exercise testing. 9. All diagnostic tests _______________ patients a certain percentage of the time. 10. _______________ is the percentage of times a test correctly identifies those with CAD. 11. ______________ is the percentage of times a test correctly identifies those without cardiovascular disease. 12. The ____________ __________ of an abnormal test (positive predictive value) is the percentage of people with an abnormal test result who have disease. 13. The ___________ ________________ value is the percentage of people with a normal test result who do not have disease. 14. A _______________ ______________ is defined as an abnormal exercise test response in a person without significant heart disease and causes the specificity to be decreased. 15. A ____________________ _______________occurs when the test is normal in a person with disease and causes the sensitivity of the test to be reduced. 16. In people in whom the probability of a false-positive or false-negative test is high, an ___________________ ____________________ (exercise or pharmacologic echocardiogram or radionuclide test) may be appropriate. Stress Testing: Chapter 19 Worksheet B 17. The most commonly used technique to evaluate myocardial perfusion is the application of the _______________ __________ ______. 18. _________________ ________________ with technetium-99m sestamibi permits higher dosing with less radiation exposure resulting in improved images that are sharper and have less artifact and attenuation. 19. Perfusion defects that are present during exercise and persist at rest _____________ _____________ MI or scar. 20. ____________ ____________ of the coronary anatomy has been shown to be somewhat more sensitive and specific than the exercise electrocardiogram for detecting CAD. 21. ________________ function is commonly evaluated with the use of the radioisotope technetium-99m. 22. ________________ imagining of the heart is being increasingly used during exercise and pharmacologic stress testing. 23. Two types of pharmacologic stress agents have been used; those that increase coronary blood flow through coronary _________________ and those that increase myocardial oxygen demand by increasing _________ _________. 24. The direct measurement of V02 has been shown to be more ______________ and _______________ than estimated values from treadmill or cycle ergometer work rate. 25. Exercise induced ST segment depression is less ______________ among women as compared to men 26. The accuracy for diagnosing CAD in ____________ has been shown to be improved by the use of multivariate methods. 27. Despite several problems posed by ______________ subjects that require additional attention, exercise testing is not contraindicated in this group. 28. The exercise test in patients who have undergone cardiac ___________________ is less a diagnostic and more a functional tool. 29. Exercise testing is increasingly being supervised by _________________________. 30. Exercise test has been shown to be of value for estimating prognosis in patients with a wide range of severity of ________________________ ______________.