Q. Explain the protocol for stress testing?

The protocol for stress testing should be structured to include the following:

1) Continuous ECG monitoring.

2) Hard copy ECG recording when desired preferably several simultaneous leads before during and after exercise and at 3 minute intervals during exercise. A minimal recording of muscle potential is essential to an artifact free recording with averaged beats at 3 minutes intervals.

3) A type of activity that can be performed by the sedentary, poorly developed and deconditioned subject as well as by the trained athlete.

4) A workload that can be varied according to the capacity of the individual but is standardized enough to deliver reproducible results and comparison with other patients tested.

5) Repeatedly frequent blood pressure measurements before during and after the exercise.

6) A way of estimating the aerobic requirements in individuals tested.

7) Maximum safety and minimum discomfort for each individual tested.

8) The highest possible specificity and sensitivity in the discrimination between health and disease.

9) A sufficient body of information available so that the response of normal and cardiac patients can be identified.

10) A first stage long enough for a warm up to occur.

11) A procedure short enough to be practical.