1-Detection of CAD .Intermediate pretest probability .High risk factors (DM, PAD, CVA...) 2-Risk stratification of post-MI patients Prior to DC = Submaximal test at 4-6 days Early = symptom-limited at 14-21 days Late = symptom limited at 3-6 weeks 3-Risk stratification of chronic stable CAD into low risk category (managed medically) or high risk category (revbascularization) 4-Risk stratification of low risk ACS 6-12 hours after presentation without active ischemia or heart failure within 5-Risk stratification of intermediate risk ACS 1-3 days after presentation 6-Risk stratification before noncardiac surgery in patients with known CAD or those with high risk factors for CAD 7-To evaluate the efficacy of therapeutic interventions (anti-ischemic drug therapy or coronary revascularization) and in tracking subsequent risk based on serial changes in myocardial perfusion in known CAD patients
1-High risk unstable angina 2-Decompensated or inadequately controlled CHF 3-Uncontrolled HTN (BP>200/110 mmHg) 4-Uncontrolled arrhythmia 5-Severe symptomatic aortic stenosis 6-Acute PE 7-Acute myocarditis or pericarditis 8-Acute aortic dissection 9-Severe pulmonary HTN 10-Acute MI (<4 days) 11-Acute illness
PHARMACOLOGIC INDICATIONS: (combined with imaging - vasodilator not dobutamine)
1-LBBB 2-WPW 3-PPM
1-HR < 100 bpm and / or exercise induced ST changes resolved 2-At least 5 minutes into recovery 3-The radiotracer should be injected as close to peak exercise as possible, encourage 1 minute walking afterwards 4-Blood pressure medications with antianginal properties (BB, CCB and nitrates) may lower the diagnostic accuracy of the test
ALL EXERCISE TESTS SHOULD BE SYMPTOM-LIMITED. Achievement of 85% of MAAPHR is not an indication to stop.
(>2 mm) or St elevation (> 1mm) in leads without diagnostic Q waves except V1 or aVR