EET (Exercise Tolerance Test )

An Exercise Tolerance Test or Stress Test records the heart's electrical activity (rate and rhythm) during exercise. 
It is one of the commonest forms of stress tests used to induce provoke cardiac ischemia for diagnostic evaluation of coronary artery disease. 

1. ETT

2. What is ETT? An Exercise Tolerance Test or Stress Test records the heart's electrical activity (rate and rhythm) during exercise.  Is one of the commonest forms of stress tests used to induce provokable myocardial ischemia for diagnostic evaluation of coronary artery disease. 

3. Equipment Required Treadmill machine or Exercise Bike 12-Leads  electrocardiograph (ECG) machine Stop Watch Leads Clips Sticking Tape

4. Procedure A progressive and maximum exercise test (starting from a walking pace and gradually increasing pace) is performed while the electrical impulses from the heart tissue are recorded by surface electrodes places on the chest wall .

5. ETT Points

6. What Does ETT Do? In ETT, (also know as stress test), it measures: Heart Rate Blood Pressure ECG

7. ETT Patient is requested to do exercise on a Treadmill machine. Duration 6 to 10 minutes

8. Useful in diagnosis of… Cardiac Arrhythmias Myocardial ischemia and infarction Pericarditis Chamber hypertrophy Electrolyte disturbances Drug effects and toxicity

9. Calculating Heart Rate

10. Normal H.R. 60-90 bpm

11. What is an ECG? An ECG is the recording (gram) of the electrical activity(electro) generated by the cells of the heart(cardio) that reaches the body surface.

12. ECG Leads Leads are electrodes which measure the difference in electrical potential between either: 1. Two different points on the body (bipolar leads) 2. One point on the body and a virtual reference point with zero electrical potential, located in the center of the heart (unipolar leads)

13. ECG Leads The standard ECG has 12 leads: The axis of a particular lead represents the viewpoint from which it looks at the heart. 3 Standard Limb Leads 3 Augmented Limb Leads 6 Precordial Leads

14. Basics ECG graphs: 1 mm squares 5 mm squares Paper Speed: 25 mm/sec standard Voltage Calibration: 10 mm/mV standard

15. ECG Paper: Dimensions 5 mm 1 mm 0.1 mV 0.04 sec 0.2 sec Speed = rate Voltage ~Mass

16. + - RA RA LL + + - - LA LL LA LEAD II LEAD I LEAD III Remember, the RL is always the ground By changing the arrangement of which arms or legs are positive or negative, three unipolar leads (I, II & III ) can be derived giving three "pictures" of the heart's electrical activity from 3 angles. Leads I, II, and III I II III

17. Other practical points Electrodes should be selected for maximum adhesiveness and minimum discomfort,electrical noise,and skin-electrode impedance Effective contact between electrode and skin is essential. ECG :calibration