I'd recommend this BMJ article for a comprehensive discussion; what follows below are just a few salient MRCP points.
ETTs are carried out according to the Bruce protocol, which is 7 sections each 3 minutes long so a maximum of 21 minutes of exercise. A modified bruce can be used in higher risk/frailer patients.
Beta blockers must be stopped the day before an ETT
Digoxin should be stopped a week before.
The test is deemed to be positive if:
- anginal symptoms
- BP decreases by 15mmHg or fails to increase on exercise
- arrhythmia
- ST depression
- failure to achieve target heartrate (220-age in men, 210-age in women)
- ST elevation
Now for the last battle of the day, lead poisoning
