Treadmill test and veloergometry: normal indices, price, indications and contraindications

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The treadmill test and veloergometry are two different versions of a similar ECG technique. In the first case, a special track( running, known as treadmill) is used for physical exertion, and in the second - a bicycle simulator. And today we will consider both methods in more detail, determine what it is and what is better, bicycle ergometry( VEM) or treadmill test, we will tell about preparation, prices and features.

What is treadmill test and veloergometry

This electrocardiography technique helps to determine individual exercise tolerance and reveals latent cardiac pathologies that occur without symptoms. The treadmill test helps to determine the degree of coronary artery flow insufficiency. Apply both types of ECG more often to identify IHD.

More details about such stress tests as treadmill and VEM will be described by the specialist in this video:

To whom they are assigned

• A sample with a load is prescribed for the diagnosis of heart diseases, to establish the presence of rhythm disturbances( especially transient ones that are difficult to establish).
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• The procedure is mandatory for people who are prone to developing cardiac pathologies due to complicated heredity, severe working conditions or due to age( over 40 years).

A treadmill test or bicycle ergometry is performed when personnel are selected for complex and extreme jobs where physical fitness and excellent health are required. Workability is also checked in people with heart diseases, which makes it possible to raise the issue of disability or restrictions in the future.

Why go through the procedure

Both types of research are often prescribed after a normal ECG, when it does not give results. Based on the results of the treadmill test, the treatment can be adjusted. Such a stress study is carried out in 2 samples, which helps to accurately select the dose of a cardiotropic drug.

The essence of testing is to accelerate the frequency of cardiac contractions to assess its response to blood supply and stress in general. Bicycle ergometry and treadmill test remain one of the best ways to recognize IHD at an early stage. This is of considerable importance for the patient, since successful therapy prevents progression of ischemia and reduces the risk of myocardial infarction.

For the types of methods for carrying out the treadmill test and veloergometry, let's talk about it below.

Types of diagnostics

• The bicycle ergometer is not an ordinary simulator, but equipped in such a way that it accurately doses the load. These devices have different types of braking system, which affects the way of formation and adjustment of this load. With a mechanical device, the regulation is carried out by means of a belt, the pressed surface of the wheel from the outside. On such a veloergometer you need to maintain the number of revolutions with the pedals at the same level( 60 revolutions per minute).The electric braking system provides braking by moving the conductor( i.e., a metal strip from the outside of the wheel) in an electromagnetic field. The load power in this case will not depend on the speed of the pedals torsion, so the patient can only make 30 revolutions per minute.
• The treadmill test is a normal walk on a treadmill. At first, walking is slow, but the task is gradually becoming more complicated, since every three minutes the angle of inclination and the speed of the track change.

Load tests are divided into the following types:

1. Test with echocardiography .Echocardiography is performed before or after the treadmill test( veloergometry).This allows not only to accurately identify coronary artery disease, but also to identify viable areas of scars after a heart attack, to evaluate the pump function of the heart muscle.
2. Routine test with ECG .
3. Loading cardiopulmonary testing treadmill test and BEM with gas analyzer. In this type of research, pulmonary activity is also fixed. It is used for different categories of patients, since the method is very accurate.
4. Testing in combination with dopplerography of of lower extremity vessels. The complex of these studies is aimed at assessing arterial insufficiency and ischemia.

Next, we will consider the indications and contraindications for conducting a treadmill test and veloergometry.

Indications for

• Disrupted lipid metabolism;
• assessing the effectiveness of drug therapy for coronary heart disease;
• pain in the heart of an atypical form, not established by a traditional ECG study;
• definition of load tolerance;
• diagnosing angina and determining its class;
• definition of the risk of hypertension;
• evaluation of restorative therapy in IHD.

About the indications for the passage of VEM and treadmill test will tell Elena Malysheva in this video:

Contraindications for

There are a number of absolute contraindications for the loading ECG:

1. unstable angina;
2. Mental illnesses that prevent samples;
3. arrhythmias with a violation of hemodynamics, which are not amenable to drug therapy;
4. thyrotoxicosis;
5. severe heart failure;
6. infection;
7. pericarditis, endocarditis, myocarditis;
8. aortic stenosis;
9. is a dissecting aortic aneurysm or a suspicion of it;
10. lung infarction and acute myocardial infarction;
11. kidney failure;
12. pulmonary embolism and other serious diseases, which can exacerbate during the test period.

There are also relative contraindications:

• pacing is not adaptive;
• stenosis of the artery;
• chronic infections( hepatitis, HIV);
• electrolyte disorders( hypokalemia, etc.);
• hypertrophic cardiomyopathy;
• hypothyroidism, diabetes mellitus or thyrotoxicosis( decompensation stage);
• complicated pregnancy and its late terms;
• heart valve defects;
• second and higher degree of atrioventricular block;
• increase in blood pressure more than 200/100 mm.gt;p.
• thrombophlebitis;
• frequent syncope;
• high degree of myopia;
• feverish conditions;
• varicose veins.

Is the

method safe? Overall, the ECG procedure with exercise is considered safe, but complications can develop in some categories of patients. Usually this happens in the presence of IHD.

• Complications can affect various areas of the body: gastric, nervous, pulmonary, cardiac, and sometimes musculoskeletal.
• Cardiovascular complications are most dangerous, as there are risks of serious problems like ventricular fibrillation, rupture of the aortic aneurysm or circulatory arrest.
• Rarely, but still able to occur strokes, pneumothorax, anaphylactic shock on the load.

Under the supervision of a specialist who monitors the strict dosage of motor activity, this does not happen. Patients after the procedure undergo rehabilitation, and before bicycle ergometry and treadmill test are prepared. After the study for a patient at risk, it is monitored that reduces the likelihood of any complications.

On how to prepare for the treadmill test and VEM, we will discuss further.

Preparing for the

procedure It is sometimes necessary to cancel certain medicines before the tests. The question about this is decided by the attending physician.

• Stop taking cardiac glycosides and digoxin 2 weeks before the cycloergometry.
• For a couple of days, they cancel sedatives, diuretics, calcium antagonists, ACE inhibitors.
• Some drugs, for example beta-blockers, can not be stopped abruptly, so as not to distort the test data, so the dosage is understated gradually.
• For a day you need to give up clonidine, and 12 hours before ECG with a load - from nitroglycerin short-acting.
• It is forbidden to stop taking antidiabetic drugs and anticoagulants.

Also:

• The patient himself must take responsibility for the upcoming procedure and not take alcohol, coffee.
• For 3 hours it is better to refuse a meal, do not smoke and do not perform difficult physical work.
• Another home you need to make a list of all the medications that are taken at the time of the test.
• For a day is better to avoid shocks and stress.
• If the patient is not in the hospital, then you need to take care of the subsequent delivery home by car.
• As for clothes, it is better to dress comfortably and easily.

How the

session is performed The ECG is recorded in 12 leads. Before the procedure begins, record the samples when the patient is at rest. In this research after the conclusion, the location of the electrodes on the body must be indicated. They are usually placed in the area of ​​ileal bones, on the shoulders, at the collarbones, on the back and waist. The cuff is also superimposed on the hand, which fixes all changes in blood pressure.

Physical load increases gradually, but it is always selected individually. An important role is played not only by the condition of the patient, but also by his age. Necessarily the person informs on the slightest changes, concerning well-being. Treadmill test stops when negative symptoms appear, the patient is tired or reaches a certain level of heart rate. Some time after this, the blood pressure level is measured, which helps to estimate the period necessary for the body to recover.

To ask for discontinuation it is necessary in case of such manifestations as:

1. severe dyspnea,
2. weakness,
3. dizziness,
4. chest pain,
5. general fatigue or fatigue of legs,
6. headaches.

How the results of the test are evaluated and their decoding is carried out after the treadmill test and veloergometry, as well as their normal performance read below.

Decoding of the results

The results are automatically deciphered, and at the end of the bicycle ergonomics a special conclusion is issued. It indicates not only the presence or absence of latent ischemia, but also the permissible load, the response of blood pressure to it. In the resulting conclusion, the following characteristics of the test are usually available:

• Clinically positive .The ECG with the load did not reveal the causes of ischemia, but the patient's complaints indicate the presence of oxygen starvation. Other types of diagnostics are required for clarification. Sometimes the test turns out to be false, in other cases it can talk about coronary atherosclerosis.
• Positive treadmill test or veloergomtery. Problems, and sometimes their etiology were established. Patients who have such a formulation in the conclusion are almost always prohibited from conducting coronaroangiography. This is especially true of people who have suffered a worse load.
• Negative result of .The most favorable, since it excludes the presence of IHD.
• Doubtful test. Diagnosis established the prerequisites for the appearance of signs of ischemia, but no accurate data were obtained. This group of patients is considered one of the most difficult, because it is difficult to choose the appropriate therapy tactics.
• Small or incomplete .Such a conclusion is given to the study, interrupted at the request of the patient. A low-level test will be because the right amount of heart rate has not been achieved. The doctor can not make any conclusions.

The average cost of the procedure

The cost for veloergometry and treadmill test depends on the type of diagnostic study. Usually the average cost is at the level of 2500-3500 rubles. About where to do( pass) treadmill test and veloergometry, ask your doctor.

Even more useful data on bicycle ergometry and treadmill test is contained in the video below: