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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes significant ST-segment changes during the exercise?

Had a Mild Positive for reversible ischaemia Patient could exercise for 06 minutes and 10 seconds of the Bruce Protocol and achieve a workload of 08 mets.He attained a peak heart rate of 176 beats/minutes which is 93% of the predicted maximum. the exercise was terminated owing to fatigue and attainment of THR. there was no classical angina. Clinically the blood pressure response was normal (BP 140/80 mmhg) and there was no S3 and S4 gallop in the recovery period. In the pre exercise there was not significant ST segment change. At peak exercise there was ST-Segment depression of -1.35 to -2.10 in lead II, IIIand Avf. in lead-1.20 to -1.60-in lead -V4-V5 and V6.
Tue, 30 Jun 2020
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General & Family Physician 's  Response
Hi,

Based on the history you have shared, a thalium scan with Calcium scoring may be a good next step to rule out any evidence of coronary artery disease as though myocardial response is good but any associated ischemia can't be ruled out based on this ETT.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Saddiq Ulabidin, General & Family Physician
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What causes significant ST-segment changes during the exercise?

Hi, Based on the history you have shared, a thalium scan with Calcium scoring may be a good next step to rule out any evidence of coronary artery disease as though myocardial response is good but any associated ischemia can t be ruled out based on this ETT. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Saddiq Ulabidin, General & Family Physician