INDICATIONS TO ECG WITH LOAD:
Detection of ischemic heart disease at an early stage.
Registration of arrhythmias during exercise, if there is a suspicion of this kind of disorder.
Diagnosis of early stage chronic heart failure.
Fixation of excessive increase in blood pressure during exercise.
Stress tests are also important for assessing the condition of patients with cardiovascular pathology.
The objectives of such a diagnosis are as follows:
assessment of the functionality of the patient with ischemic heart disease and chronic heart failure;
determination of exercise tolerance;
evaluation of the correct functioning of the pacemaker;
assessment of the dynamics of the patient's condition after myocardial infarction in the course of treatment;
assessment of the rate of rehabilitation in the postoperative period.
TESTING
1.Data logging at rest (ECG, Echo-KG, measurement of blood pressure and other parameters). It is important for the patient to come to the study in advance, take a break at the doctor's office, allow the heart to restore a normal rhythm.
2. The main part of the study - stress test. The test load may be physical or drug. In the first case, the patient is injected with a special drug that makes the heart work in a mode as during exercise. In most cases, the background of the load relieves the ECG in 12 leads. At the same time, echocardiography or other methods of detecting myocardial ischemia can be used (for example, with the introduction of
radioactive isotopes at the height of the load).
- The patient is given time to rest, after which he again checks the work of the heart. In addition, data can be recorded continuously, for example, within 10-15 minutes after the end of the load. In this case, the doctor receives a complete picture of how the heart rhythm and blood pressure are restored. Depending on the type of execution, testing can last from 15 minutes to several hours. Bicycle ergometry and treadmill test usually require about 1 hour of time.
PREPARING FOR ECG WITH LOAD
Before conducting a diagnostic load test, the patient should stop taking nitrates for at least 24 hours, and beta-blockers for at least 48 hours before the start of the study. At the same time, if it is necessary to evaluate the effect of antianginal drugs on exercise tolerance in a patient with established angina, the drugs are not canceled.
A positive test with a load (that is, a test that revealed clinical signs of ischemia and corresponding changes on the ECG) becomes an indication for the study of coronary arteries with the introduction of a contrast agent into the vessels (complete coronary angiography).
Contraindications for stress test
- acute myocardial infarction, the first 2 days.
- deep vein thrombosis, pulmonary thromboembolism.
- unstable angina.
- acute inflammatory diseases of the heart - myocarditis, pericarditis, endocarditis.
- tachyarrhythmias.
- blockade of the cardiac conduction system
- severe arterial hypertension (above 200/100 mm Hg. Art.).
- hypertrophic cardiomyopathy.
In the process of conducting a stress test, the patient is under the supervision of a cardiologist. Exercise is stopped if the following symptoms appear during the study:
- A sharp increase in blood pressure;
- pallor or cyanosis of the skin;
- severe pain in the chest, an attack of angina;
- serious rhythm disturbance;
- ECG measurements indicating oxygen starvation of the heart muscle;
- dizziness, darkening of the eyes;
- Any significant deterioration in the patient's well-being.