Exercise Testing
As early as 1930 changes in the electrocardiogram were recognized as indicating decreased blood flow to the heart and producing the clinical condition of angina pectoris. During the next 40 years, use of the electrocardiogram combined with graded exercise (on a stationary bicycle or treadmill) became the predominate noninvasive test used in the assessment of patients with potential cardiovascular disease. Over the past 10 years improvements in myocardial perfusion imaging with radioisotopes and echocardiographic assessment of left ventricular function have been coupled with exercise to enhance detection of underlying coronary disease. In the modern exercise laboratory 75 percent of tests are coupled with an imaging modality. In addition, radionuclide imaging following the use of medications which either promote dilatation of the coronary arteries or produce increased heart rate and blood pressure, allows assessment of coronary artery disease in individuals who are unable to exercise.
At Hartford Hospital five fully equipped and staffed exercise labs are located within the sections of echocardiography and nuclear cardiology. One lab is dedicated to research in exercise physiology and nuclear cardiology. A second lab is used primarily with echocardiographic imaging of the heart under exercise conditions. In the remaining three labs approximately 20 examinations are performed on a daily basis combining exercise electrocardiography with cardiac imaging using radioisotopes. |
