Exercise stress testing
Principle and modern role
- Graded exercise (Bruce protocol commonest) with continuous ECG, BP and symptom monitoring
- Principle: inc myocardial O2 demand until supply becomes limiting -> ischaemia -> ST depression, symptoms, or haemodynamic failure
- Modern role has narrowed markedly: CTCA and functional imaging have displaced it for the diagnosis of CAD. Its surviving value is functional capacity, exercise-induced arrhythmia and risk stratification**
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