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March 2004, Volume 34 Number 3 , p 28 - 28


  • Joan E. King RN, C, ACNP, ANP, PhD




    I care for many patients who've undergone various cardiac tests before surgery. Which tests are appropriate for which patients, and why?—G.T., ORE.

    Joan E. King, RN, C, ACNP, ANP, PhD, replies: Preoperative evaluation usually begins with a 12-lead ECG . If the patient's preoperative ECG is abnormal or he has a history of angina or other cardiac symptoms, more diagnostic tests are indicated. The American College of Cardiology and American Heart Association (ACC/AHA) guidelines recommend using the most accurate and most cost-effective test for the patient's history and signs and symptoms.

    In the simple stress test , the patient walks on a treadmill while connected to an ECG machine; his heart rate and blood pressure are monitored while he walks. The treadmill's speed and grade are increased every 3 minutes until the patient tires or achieves the target heart rate, or until he develops clinically significant ...

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