Exercise Tolerance Test


Hi Richard, my name’s Frances I’m the cardiology
nurse consultant. Your GP sent you up to the clinic this morning to have an Exercise Tolerance
Test done. You’ve obviously been complaining of some chest pain, is that right? Yes, mostly
in the centre of my chest, some tightness. Probably for the last couple of weeks to a
month. That tight feeling, does it go anywhere else, down your arms or up your jaw? No, it
just seems to stay across the centre part of my chest. OK, does it make you feel breathless
or sick? No I feel slightly warmer, maybe a bit sweaty. But I don’t feel breathless
or sick. And you’re not aware of your heart beating fast in your chest or anything like
that? No, I don’t think so no. Not at all. And you say you can get it when you’re exercising,
but you can also get when you’re at rest as well. And the next thing I’m going to do is just
bring some cables across, ‘cos obviously we need to attach up all these. So we can have
a look at your initial heart tracing. So we’ll just wire you up to this little lot now (here
you go). Have you been on a treadmill before at all? I have yeah, I’ve used a treadmill
before. At the gym or somewhere like that? Yeah, at the gym. So you’ve got a rough idea
of what we’re going to do you today. The idea is we’re going send you for a walk, up a bit
of a hill. OK. The most important thing is you’ll let us know straightaway if you start
to feel any of that chest discomfort, or any problems at all (that you’re having). OK.
Now obviously Frances and I will be with you the whole time. And we’ll be monitoring your
blood pressure and your heart rate very closely. As well as some other things. But please let
us know if there’s any changes that worry you. OK. OK, we’re just going to pop the belt around
your waist, which will keep everything attached to you during the test (thanks, that’s great).
Lovely, great. So that’s you. We’ll get you down from there now and we’ll show you what
to do and get you on our treadmill. Richard I’m just going to put this blood pressure
cuff on your arm. I will record your blood pressure a few times throughout the test.
You will hear a bleep in the machine, don’t worry about that, that’s just to remind me
to take a blood pressure. Your blood pressure will go up through the test and your heart
rate will go up through the test. But that’s a natural response to exercise and that’s
what we’re looking for. OK. Just before we get started, I’ve a last set of instructions
for you. When the belt starts moving what we want you to do is start walking straightaway,
keeping up to the top half of the treadmill all the time here. Once you get comfortable
you’re gonna go up a small gradient into level one. And that’s gonna be you for the first
few minutes of the test, so I want you to really relax and take your time with that.
Importantly, like we were saying earlier, let us know straightaway if you feel any of
this chest discomfort you’ve been getting or anything symptoms that’s bothering you,
alright, you just let us know. OK, no bother. OK, we’re gonna get started with the test
now, so if you can take a long slow stride, right up to the top of the treadmill for us.
That’s the way, good. And now I’m gonna put you up the small hill, and that’s just gonna
get you into level one, OK. Good stuff, if you can just take your time with that. First
three minutes, if you can let us know if there’s any problems. How you feeling at that? Yeah,
that’s fine, no problem. Great. ((treadmill whirring)) OK Richard, you still feeling fine there at
the moment? OK, I’m quite warm, but I’m OK yup. Good, well we’re gonna get you into level
two. Which means slightly faster and slightly steeper. Now it’s just gonna change over in
five seconds alright, you’re gonna hear it moving up a gear. Right, now. That’s you up
in level two. How you finding that? It’s OK. Great, good. You’ve no chest pain at the moment
Richard? No, I feel fine. Good. ((treadmill whirring)) OK that’s you finished level two now. So we’re
gonna make it a little bit faster and steeper again provided you’re feeling OK still. Yeah,
I feel fine thanks. None of that discomfort at all? Nothing. OK, it’s about to get faster
and steeper for you… now. It’s quite hard work this one, bit more of a quicker walk
for you. (OK). ((treadmill whirring)) That’s you finished the test there, so we’re
gonna just start slowing things down now. If you can keep walking straight to the top,
until it comes to a halt. Now when it does stop, you might feel a little bit lightheaded
and giddy. Don’t want you to worry about that, it’s quite normal, alright. We’re just gonna
start slowing things down now. If you could just keep walking to the top and we’ll bring
you to a halt now, OK. Great, that’s you. Well done. Hi Richard. I’ve got the result of your exercise
test and it’s looking good. (Good). You did nine minutes on the test, you had no symptoms
while you were on the test and your (ECG’s) trace and your ECG’s actually looking fine.
There’s no abnormalities in it that we would be concerned about. (Good, OK). So thinking
about your symptoms, you presented with a rather atypical presentation for angina. And
your treadmill test is very good. So what we would be saying is, this is certainly not
angina. What I’ll do now is, is write to your GP, tell him that you have been up to the
clinic, you’ve done your treadmill test and everything looks fine.
How do you feel about that? Quite relieved, it’s obviously not related to my heart or
angina. So yeah, quite happy. I obviously didn’t experience any signs or symptoms when
I was on the test, so, yeah pretty relieved. (OK).

Daniel Yohans

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