The effort electrocardiogram

Normally during physical effort force and frequency of contraction of the heart grow with the aim of ensuring a cardiac output optimally, adapted to the needs of the growing oxygen. There are situations of disease although the heart operates normally in conditions of rest, its ability to adapt to the efor tests reduced. These patients have the typical symptoms of effort (ex: chest pain, you breathe difficult – dyspnea), in the rest position being asymptomatic carriers. Testing of effort allows, thus, identify bad of any anomalies of cardiac function responsible for the symptoms pacientu him and which are not evident in the rest position.

The electrocardiogram of effort (ECG test of effort) allows to identify changes the electric risk factors include obesity type consequence of insufici perfusion ente of the heart in conditions of effort in the presence of significant ingustari (stenosis) at the level of the coronary arteries.
The sample of effort seeks to specify in the course of a physical effort, the behavior of the main hemodynamic variables, which are: the frequency of the heart rate and blood pressure and detect, the existence of symptoms anormaIe (chest pain, sorry, flutter) or of anomalli electrocardiographic devices (disorders or disorders of ventricular repolarization in the phase of recovery diagram) showing a coronary insufficiency).

Indications

The electrocardiogram of effort is recommended for diagnosis of coronary disease ischemic symptoms. Coronary arteries are the blood vessels that supplies the heart with oxygen and nutrients. Coronary disease cardiopathy consists in suffering cardiac muscle as a result of the reallocation of coronaries in the process of atherosclerosis. Through the accumulation of deposits which contain cholesterol (embedded aterom), coronaries may be significantly narrow (SA), which would result in a reduction of blood flow by delivering and symptoms (chest pain or difficult breathing), and in particular in terms of effort. Thus, if you have pain in the chest or breathing difficult to effort, the electrocardiogram of effort may show if these symptoms are determined by the disruption of the coronary arteries.

What is the test?

 An electrocardiogram is practiced first in the horizontal position of the sick man, then one in the sitting position and the other to his feet. With the electrodes placed on appropriate places, the patient performs a physical effort on a bicycle ergometrica or on a slideway. The conduct of the test of effort is liberties are fore opaque depending on the sick and the information desired and obtained by increasing the resistance applied to the pedal the bike or increase the speed of the actuators of the rug rolling stock and/or increase its slope.During the test the heart rate, pressure blood pressure and electrocardiogram are recorded in every minute in a systematic way, or where there is a symptom, then every minute during the slip into oblivion as far as both the force (approximately 6 minutes) or up to the disappearance of the symptom.

Surveillance. Although wholly free of danger in most cases, the sample of the effort is practiced by a qualified physician that has a defibrillator and a material to resuscitate next generation be ad apted. The sample does not require hospitalization.

Before the beginning of the test, you will be asked about the medical history, symptoms, medicines which they take.You will also be asked about the ability of effort (type and level of force on which you are able to carry out) for the establishment of the Protocol for the appropriate stress you. 
You will be seated on a special meal of stress (a bicycle attached to a table what can tilt the side). You will have more support points (at hip level and left arm) so that there is no risk to looneys during the test. You will apply electrodes on the chest and arms, connect by cables from an electrocardiograph which will register the electrical activity of the heart (electrical signals which determine the heart beats.

During the investigation, the doctor will monitor blood pressure The weight of stress will tilt to the left in such a way that the position to allow viewing of ultrasound heart. Will register a series of images ecogra fice in rest position (before the beginning of the fishing effort). Then, you will begin to be active pastime with a specific frequency shown on the order of a physician. Resistance to stress will increase every 2 minutes so that the effort which leads it will gradually increase. The duration of the test will depend on the symptoms and the ability of the effort that you have. 
The target is to make the effort of around 8 minutes so HR (heart beats)to increase at a certain value calculated for your age.

Risks

The test was echocardiographically diagnosed of effort is one of course, possible complica tions being very rare. That any medical procedure presents a series of possible adverse reactions such as hypotension. Blood pressure may fall during effort, or immediately after switching off the effort producing dizziness. This sensation will disappear quickly after stopping the effort.
During the test the stress blood pressure in normal mode will increase. Some patients may have a reaction-type exaggerated, whether or not accompanied by the symptoms (ex: headache, dizziness, tinitus). 
At values of the arterial pressure over 220/110 mmHg test shall be interrupted. Disorders of heart rate (arrhythmias). Arrhythmias may occur during autolimitandu effort to rule after stopping the test.

Preparation

It is advisable to rest position the food and avoid smoking by 2 to 3 hours before the test of effort. 
Medicinal products shall be administered in the usual way. To stop any medicinal product (e.g. beta bugs) will be done only at the suggestion of the physician. It is advisable to wear clothes and his boots comfortable during the test of effort.

Results

The sample of effort allow quantification of the level of the effort that to show signs of ischemia miocardica, the absence or other changes electrocardiographic devices. The existence, to effort, of various disorders of the intercom rite rate or the evolution of the pressure values of a patient's arterial blood pressure hipertensiv may be specified. 
If the information obtained during the effort shows that the heart is functioning normally when you will no longer need additional tests. 

If the result of the test of stress suggests this reallocation coronaries then you will eventually need further investigation, as well as the coronarografia view the coronary arteries). 
If during the test of stress will appear arrhythmias or changes which would suggest an affectation of the cardiac valve, then the treatment plan will be determined on the basis of this information.