Load tests (TREADMILL TEST, VEM)

Mandatory list of documents for research:

• Referral (form # 057 / y) and an extract from the ICAB (form # 027/y) - if the study will be conducted in another building of the polyclinic or another MO.
• Data from previous studies/inpatient treatment - if available.

Patient preparation

It is necessary to cancel (or adjust the therapy individually) the following drugs before the study:

• beta-blockers-cancellation 48-72 hours before the study;
• nitrates, vasoactive drugs-cancellation on the day of the study;
• antiplatelet agents - control of therapy.

The patient should take all the medications that are constantly taken with them to the study. Adequate correction of blood pressure indicators against the background of temporary withdrawal of beta-blockers is a prerequisite.

On the day of the study:

• do not take blood tests;
• do not smoke or drink coffee 2 hours before the study;
• light breakfast-no later than 2 hours before the study;
• for men with intense hair, it is advisable to shave their breasts;
• take sports pants, socks, sports shoes.

Information on conducting the study

• Before the examination, electrodesattached to a computer are applied to the patient's body. With their help, an electrocardiogram is recorded, which is displayed on the monitor in real time.
• During the exercise test, the patient turns the pedals of the exercise bike. At each stage of the study, the load will increase.
• The duration of each stage is 2-3 minutes. Beforeand during the examination, the nurse monitors the patient's blood pressure. The doctor monitors the patient's electrocardiogramand his well-being.
• Reasons for stopping the stress test:

• the appearance of symptoms that require stopping the load (chest pain, weakness, shortness of breath, lameness);
• severe depression ST >2mm;
• elevation ST > 1 mm;
• significant arrhythmia;
• steady decrease in systolic blood pressure;
• severe hypertension (systolic blood pressure > 250 mm > Hq or diastolicblood pressure >115 mm > Hq) no DBP parameters specified;
• achieving the maximum calculated heart rate for this patient;
• the patient's refusal to continue the load. If the stress test was terminated at heart rate);
• to assess the significance of CHD in a patient and determine the treatment strategy, it is necessary to calculate the Duke index: load time -(5 x ST deviation) - (4 x angina index). If the Duke index is less than -11, the patient has a high risk of adverse cardiovascularevents. It is necessary to resolve the issue of conducting a coronarography;
• ECG stress test has no diagnostic value in the initial LDL block, pacemaker rhythm, WPW syndrome.

• Contraindications for the stress test:

• ACS;
• hemodynamically significant arrhythmias;
• active endocarditis;
• symptomatic severe aortic stenosis;
• decompensated heart failure;
• TELA;
• active myocarditis or pericarditis.