Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “EXERCISE TEST”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 955 records · Page 53Linked to original sources
PubMed1982

Methods of exercise testing and training prescription for cardiovascular diseases.

Physical exercise testing and training in health and in heart disease may differ in concepts, targets and interpretation. Untrained males (n = 1962) of different age (18-65 years)--638 apparently healthy, 121 with arterial hypertension stage I-II, 1140 after confirmed acute myocardial infarction, and 63 after mitral surgery--were submitted to near-maximal bicycle spiro-ergometry (sitting, 60 rpm). Correlations between oxygen uptake (VO2), external work (W), heart rate (HR), systolic blood pressure (BP), double product (HR x BD = DP, as an indirect index of myocardial oxygen uptake), and other derived indices, varied substantially. The mutual predictive power of non-invasive cardiocirculatory parameters was weak particularly at low and moderate exercise (50-100 Watts). Different factors of priority influenced the variety in regression equations obtained in the separate groups. Discriminant values and limits rather than "norms" seem more appropriate in order to select the most relevant intervention (physical training, medical treatment, surgery). "Optimization" of disturbed inter-factor relations (e.g. of HR, BP, DP, W, VO2, VO2/kg, mechanical efficiency) may define the integral target of physical training in cardiac patients, if indicated. "Target-oriented" exercise prescription is discussed with examples. The cardiac cost of physical work (DP/VO2) is assessed in various heart conditions with its implications on exercise prescription. An attempt is made at differentiating between training the patient and "training" the diseased heart, and some controversies in terminology and in practical approach are stressed.

Adult↗
PubMed1991

[The value of early exercise testing in patients with myocardial infarction complicated by evolving left ventricular aneurysm].

The values of an early exercise test limited by criteria for test termination were compared with coronaro- and ventriculographic measurements made 2-3 days after the test in 51 males of working age who suffered from transmural myocardial infarction complicated by local aneurysm in 12 cases and by overall left ventricular aneurysm in 39. The exercise test performed in the early periods was found to substantially increased its sensitivity. The isolated ST-dominant segment elevation in patients with local aneurysm and isolated coronary artery lesion indicated that the patients had a favourable prognosis. On the contrary, the combination of two criteria or more of a positive test in patients with global aneurysm and multivessel disease suggests that the patients with temporary disability should be followed up. The presence of T-dominant ST-segment elevation, anginal pain concurrent with an inadequate BP elevation shows that there is a high risk for postinfarction complications.

Adult↗
PubMed1995

Fuzzy cluster analysis of positive stress tests, a new method of combining exercise test variables to predict extent of coronary artery disease.

Fuzzy set theory is useful in the analysis of data having a graded degree of abnormality. Previous studies using sharp cutoff points between normality and abnormality have resulted in general guidelines for the interpretation of positive stress tests, but do not enable the clinician to simultaneously combine several stress test variables, each having a range of abnormality. In this study, positive stress test results from 109 patients were reviewed. An angiogram recorded within 1 month of the stress tests showed that 100 patients had coronary artery disease (CAD) (15 had left main CAD, and 27 had 3-vessel, 30 had 2-vessel, and 28 had 1-vessel disease) and 9 were normal. Six variables were selected for fuzzy cluster analysis: ST-segment change, difference between resting systolic and peak exercise systolic blood pressure, total treadmill time, peak exercise heart rate as a percentage of 100% predicted maximum for age, time to onset of angina, and duration of repolarization abnormalities. The analysis used a similarity measure to compute how closely each stress test resembled a prototypical mildly, moderately, or severely abnormal stress test. Stress tests classified by this method showed better correlation with the extent of CAD than the degree of ST-segment depression alone. Unlike tests with mild degrees of ST depression (0.5 to 1.5 mm), tests classified as mild by the method virtually excluded high-grade CAD.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Exercise test: arrhythmogenic or antiarrhythmic? Rate-dependency vs. adrenergic-dependency of tachyarrhythmias.

The arrhythmogenic effects of exercise tests are often unpredictable, sometimes paradoxical, and usually poorly reproducible. This explains why they are rather neglected by rhythmologists in studying the mechanisms of arrhythmias and the effects of antiarrhythmic drugs and why their prognostic value is a matter of controversy. At the same time the induced, supposedly ischaemia-related arrhythmias are usually not prevented by revascularization procedures. All these discrepancies are probably explained by the complex interactions between the time-limited stimulation of the sympathetic drive and the arrhythmia mechanisms. During the exercise test the sympathetic drive is increased via the neurogenic and humoral routes, and the post-exercise period is characterized by a vagally-induced deceleration of the heart rate which intervenes in the setting of a persistent high level of sympathetic activity. The arrhythmia components formed by potential triggers (isolated premature beats) and substrates (repetitive activity) do not react in the same way to those different phases. Extrasystoles are mainly rate-dependent, so that they often tend to disappear as the sinus rate accelerates. The repetitive ventricular activity directly depends on the sympathetic drive, but necessitates the presence of the trigger to become manifest. Conceivably, many different situations may result from the complex interplay between these distinct parameters, so that the apparent clinical effect of exercise may be either arrhythmogenic or antiarrhythmic in apparently identical diseases, or even in the same patients.

Arrhythmias, Cardiac↗
PubMed1987

Prognostic importance of early exercise testing in men with suspected unstable coronary artery disease.

In 276 men with suspected unstable coronary artery disease i.e. recurring chest pain of new onset, increasing symptoms of anginal chest pain in formerly stable angina pectoris or suspected non-Q-wave infarction, an exercise test was performed 2-7 days after admission. Coronary events i.e. cardiac death (N = 4), Q-wave infarction (N = 11) and coronary artery bypass grafting (N = 34), were registered during one year follow-up. The indication for bypass grafting was incapacitating angina pectoris despite medication, and suitable coronary anatomy. Stepwise multiple regression analysis showed that S-T segment depression and limiting chest pain were the most important prognostic parameters regarding coronary events. In patients with S-T segment depression greater than 0.1 mV or limiting chest pain (N = 94) the occurrence of Q-wave myocardial infarction or cardiac death was 10.6% (N = 10) compared to 2.8% (N = 5) in patients without these criteria (N = 182) (P less than 0.01). Coronary artery bypass graft surgery was performed in 33% (N = 31) of the group with S-T segment depression greater than 0.1 mV or limiting chest pain but in only 1.7% (N = 3) of the other patients (P less than 0.001). Thus, in patients with suspected unstable coronary artery disease, whose symptoms and signs of ischaemia are stabilized by medication, an exercise test can safely be performed after a few days ambulation in the ward. The early exercise test provides important prognostic information regarding the risk for severe coronary events within the next year.

Adult↗
PubMed1976

Multiple lead ECG submaximal treadmill exercise tests in angiographically documented coronary heart disease.

One hundred patients underwent submaximal exercise tolerance testing and coronary cineangiography. Sixty-six percent of the exercise tests were diagnostic including 48 positive and 18 negative tests; 34 patients had indeterminate test results. The occurrence of exercise induced ventricular premature beats was not related to significant coronary artery disease. Ventricular asynergy was significantly more frequent in patients with positive exercise tests (p less than .0001). Application of the age-adjusted target heart rate criterion recommended from Scandinavia and Myrtle Beach to patients with indeterminate results due to failure to reach target heart rate resulted in six false negative tests and lowered sensitivity. The number of positive diagnostic responses achieved using a multiple electrocardiographic lead system was compared with positive diagnostic responses detected in a single lead (V5) and the number of positive tests identified by the additional leads was highly significant (p less than .0001). A high incidence of indeterminate test results due to failure to achieve target heart rate is noted.

Adolescent↗
PubMed2006

Is exercise testing useful to improve the prediction of coronary events in asymptomatic subjects?

OBJECTIVE: The value of exercise testing (ET) in asymptomatic subjects remains controversial and is unknown in countries with a low coronary heart disease (CHD) incidence. The aim of this study was to investigate the ability of ET to improve the prediction of a first coronary event in such a population. METHODS: Using a prospective cohort study, 1051 consecutive healthy asymptomatic adults were enrolled in a cardiovascular screening program including ET. The pre-test risk of CHD was evaluated by the 10-year Framingham risk function. Positive ET was defined as a horizontal or downsloping ST-segment depression >/=1.0 mm. The primary outcome was total coronary events (CE) occurrence, including cardiac deaths, acute myocardial infarction and stable or unstable angina. The mean follow-up period was 6 years. RESULTS: Subjects were aged 18-79 years and 36% were women. A total of 89 subjects (8.5%) had a positive ET. Positive exercise testing was associated with CE occurrence in a univariate analysis only in subjects with higher pre-test risk, defined by a 10-year Framingham risk >10.4% [hazards ratio (HR)=2.61; 95% confidence interval (CI) (1.07-6.40)]. In this risk category, ET was able to provide incremental information over the major risk factors in both men and women [risk factor-adjusted HR for positive ET=2.86; 95% CI (1.14-7.20)]. This risk excess in subjects with positive ET persisted even when a coronary revascularization was performed. Subjects with intermediate pre-test probability (10-15%) and positive ET had a post-test probability of CE largely equivalent to the probability in subjects with known CHD. CONCLUSION: Additional information provided by ET in subjects with a pre-test risk at 10-years >10% should lead to a more efficient use of risk-reducing therapies than it would be the case in this risk category with the analysis of traditional risk factors only.

Adolescent↗
PubMed1985

Value of lead V4R in exercise testing to predict proximal stenosis of the right coronary artery.

To assess the value of lead V4R during exercise testing for predicting proximal stenosis of the right coronary artery, 107 patients were studied. In all patients, a Bruce exercise test with the simultaneous recording of leads I, II, V4R, V1, V4 and V6 was followed by coronary angiography. Apart from registering ST segment changes in the conventional leads, all patients were classified according to absence or presence of an ST segment deviation of 1 mm or greater in lead V4R. Seventy-nine of the 107 patients were studied because of inadequate control of angina pectoris. Seven patients had had myocardial infarction before 40 years of age. Twenty-one patients were analyzed because of severe cardiac arrhythmias. In the 46 patients who had a previous myocardial infarction, the infarct location was inferior in 28 and anterior in 18. Seven of the 14 patients without myocardial infarction and significant proximal stenosis in the right coronary artery showed an ST segment deviation of 1 mm or greater in lead V4R during exercise. This was also observed in 11 of 18 patients with an old inferior wall infarction and proximal occlusion of the right coronary artery. None of the 53 patients without significant proximal stenosis in the right coronary artery showed exercise-related ST segment changes in lead V4R. Exercise-related ST segment deviation in lead V4R had a sensitivity of 56%, a specificity of 96% and a predictive accuracy of 84% in recognizing proximal stenosis in the right coronary artery. These observations indicate that the recording of lead V4R is of value for predicting or excluding proximal stenosis in the right coronary artery.

Adult↗
PubMed1980

Symptom-limited vs heart-rate-limited exercise testing soon after myocardial infarction.

To develop guidelines for exercise testing soon after uncomplicated myocardial infarction, 93 men completed a heart-rate-limited (HRL) protocol and 107 completed a symptom-limited (SXL) protocol 3 weeks after the acute event. In the HRL protocol, effort terminated at a heart rate of 130 beats/min in the absence of a limiting symptom, exertional hypotension or ventricular tachycardia. Peak heart rate was not an end point in the SXL protocol. Despite a higher peak heart rate and work load in patients who completed the SXL protocol, the prevalence of exercise-induced ischemic ST-segment depression and ventricular ectopic activity was similar in the two groups. No complications occurred with either protocol. Twelve patients (6%) had cardiac events within the next 2 months. Regardless of the test protocol used, early events were more common in patients with ischemic ST-segment responses (15%) than in patients without ischemic responses (3%) (p less than 0.01). In contrast, exercise-induced ventricular arrhythmias were not predictive of early events. Eleven weeks after infarction, when all tests were SXL, the prevalence of exercise-induced ischemic ST-segment depression and premature ventricular complexes was similar to that at 3 weeks. We conclude that SXL and HRL exercise test protocols reveal a similar prevalence of ischemic ST-segment depression and ventricular ectopic activity soon after uncomplicated myocardial infarction.

Angina Pectoris↗
PubMed1991

[Treadmill exercise test in patients with hypertrophic cardiomyopathy with and without coronary artery disease].

We studied whether the treadmill exercise test can discriminate between normal and significant narrowing of coronary arteries in patients with hypertrophic cardiomyopathy (HCM) accompanied with chest pain, and we compared the extent of myocardial ischemia during exercise. Thirty one patients with HCM were divided into two groups; 21 with normal coronary arteries and 11 with significant narrowing of coronary arteries. The treadmill exercise test was carried out in both groups. The following parameters were more frequently seen in the group with coronary stenosis. (1) short treadmill time (338, sec vs 542, p less than 0.05). (2) delta SBP less than or equal to 60 mmHg (delta: end point minus rest, 10 cases vs 12, 0.05 less than p less than 0.1). (3) significant delta ST depression (0.17 mV vs 0.05, p less than 0.05). (4) large delta ST/delta HR (3.3 microV.min/beats vs 0.7). delta ST/delta HR greater than or equal to 2.0 was the most useful for differentiating the two groups, and it was 90% in index both sensitivity and specificity for diagnosis of HCM with significant narrowing of the coronary arteries. It was concluded that treadmill exercise induced more severe myocardial ischemia in patients with HCM who had significant narrowing of the coronary arteries than in patients with HCM who had angiographically normal coronary arteries. The delta ST/delta HR was the most useful index for diagnosis of HCM with significant narrowing of the coronary arteries.

Blood Pressure↗
PubMedDate not supplied

Clinical applications of cardiopulmonary exercise testing.

Noninvasive measurement of metabolic and cardiorespiratory variables can be readily obtained using computerized systems as part of exercise testing of patients on a cycle ergometer or treadmill. The major indications for CPEX are: to assess exercise-related symptoms, especially dyspnea and chest pain; to measure exercise capacity including acceptability of patients with end-stage heart disease for cardiac transplantation; to evaluate for impairment/disability; to establish safety and guidelines for exercise training; and to assess response to specific therapy. As most patients with chronic cardiorespiratory disorders reduce their activities and consequently become deconditioned, CPEX should be considered as part of the initial evaluation. The results of CPEX should enable the physician to understand the reason(s) for the patient's exercise limitation and usually support the recommendation that the patient participate in a reconditioning or rehabilitation program. Should expired gases be measured as routine for all exercise tests? The use of CPEX depends on the clinical question. If the question is, "Does the patient have ischemic heart disease?", then a standard "cardiac stress test" is adequate. If the clinical question is, "Why is the individual limited in exercise ability?" or "Why is a patient breathless with activities?", then comprehensive CPEX is indicated. One important issue relating to CPEX is cost effectiveness. Do the results of CPEX justify the expense? There are little if any data to answer this question. However, if CPEX can establish a specific diagnosis, exclude significant heart disease, estimate work capacity, and/or provide guidelines for prescription of exercise intensity, this information may be invaluable to the individual patient and to the health-care provider. It is possible that CPEX may answer a specific clinical question and thereby actually eliminate the need and reduce the cost of additional expensive diagnostic tests. A prospective assessment of the cost effectiveness of CPEX will be important for select clinical problems.

Chest Pain↗
PubMed1988

Predicting return to work after acute myocardial infarction. Significance of clinical data, exercise test variables and beta-blocker therapy.

Among 66 full-time employed men surviving an acute myocardial infarction (AMI) and participating in the Norwegian postinfarction study with timolol, 50 (75.7%) resumed their previous work within 12 months, and 16 (24.3%) retired. Stepwise logistic regression analysis of clinical data and of results from an exercise test 3 months post AMI revealed the following factors of independent predictive value for enhanced return to work: previous labor characterized as light or moderately heavy (p = 0.001), low age at the time of infarction (p = 0.001), timolol treatment (p = 0.009), ability to stop smoking post AMI (p = 0.006), and a high exercise capacity on the exercise test (p = 0.016). It is concluded that the clinical history and an exercise test 3 months after AMI can identify patients who are more likely to resume work, and that post-AMI beta-blocker treatment with timolol and ability to stop smoking are predictive of an enhanced return to work.

Adrenergic beta-Antagonists↗
PubMed1985

Performance, ventilation, and oxygen consumption in three different types of exercise test in patients with chronic obstructive lung disease.

Seventeen patients (six men and 11 women, mean age 66 years) with severe chronic obstructive lung disease (mean FEV1 0.8 (SD 0.3)1) performed three different types of exercise test on four occasions within one week. Three daily doses of placebo tablets were given between the third and fourth attempt at each test. The tests were the 12 minute walking test, a fixed rate and height paced step test, and a cycle ergometer test in which the work rate was increased by 10 watts each minute. Performance increased significantly (p less than 0.01) between the first and fourth attempts in each type of test (12 min walking distance 16% (SD 20%); steps climbed 96% (74%); duration of cycling 29% (41%]. There was a trend for the increase in performance between successive attempts to become progressively smaller but this was not significant. No effect of placebo on exercise performance was detected. The greatest intersubject range of performance was seen in the step test (14-126 steps) and the least in the walking test (438-1014 m). Significant correlations (p less than 0.01) were observed between performance in all three types of exercise test, but the correlations found between the results of the various tests of exercise performance and the FEV1 and the FVC were either weak (p less than 0.05) or non-significant. Ventilation (VE) and oxygen consumption (VO2) were subsequently measured and compared in eight patients during all three types of exercise test. Both the VE and the VO2 that were achieved in the step test were significantly greater than in either the cycle or the walking test. No patient was able to reach and sustain steady state values of VE and VO2 in the step test, whereas a steady state for both VE and VO2 was reached and sustained by all eight patients in the walking test. It is suggested that at least three practice attempts at any exercise test should be made before the introduction of either placebo or specific pharmacological treatment and that even then it may be necessary to allow for the effects of further repeated testing in the assessment of the results of treatment.

Aged↗
PubMed1985

Submaximal predischarge exercise testing after myocardial infarction: prognostic value and limitations.

The prognostic value of abnormalities resulting from predischarge submaximal treadmill exercise testing was evaluated in 222 patients after myocardial infarction. The presence of the following variables--ST segment depression and elevation, an abnormal blood pressure response, limited exercise duration, angina pectoris, ventricular arrhythmias--were predictive of subsequent cardiac events (P less than 0.001) among the 154 patients with one or more of these abnormalities. When the presence or absence of specific variables was assessed, only an abnormal blood pressure response, limited exercise duration (P less than 0.001), and ST segment elevation and shift (P less than 0.05), were significantly associated with cardiac death. Exercise-induced angina was predictive only of the development of subsequent angina (P less than 0.05), and ST depression was associated only with future coronary surgery (P less than 0.01). Ventricular arrhythmias had no independent prognostic value. Markers of left ventricular dysfunction elicited by submaximal exercise testing are therefore valuable in identifying patients at high risk of death after infarction. Hallmarks of residual reversible myocardial ischaemia are of limited prognostic importance. The test result may be useful in selecting patients for coronary angiography.

Adrenergic beta-Antagonists↗
PubMed1991

Endpoints of treadmill exercise testing for functional evaluation of patients with mitral stenosis.

The study was performed on 122 patients proved by catheterization to have dominant mitral stenosis so as to define proper endpoints of exercise testing for functional evaluation. This represents the 14-year experience with mitral stenosis in our exercise laboratory. Of them, we investigated 126 who completed clinically event-free Naughton treadmill exercise tests. Excess peak exercise heart rates (over 150 beats per minute, 63%) and exertional hypotensive responses (59%, probably including factitious responses due to unreliable indirect pressure readings) did not correlate with the severity of mitral stenosis. Without limiting symptoms and major ventricular arrhythmias, either of the above as endpoints may cause the test to be halted prematurely in half the cases. Ventricular arrhythmias (60%; in complex forms, 20%; possibly contaminated by aberrancy in atrial fibrillation and aggravated by digitalis/diuretics) did not correlate with severity of stenosis either, but the only one major complication we met was secondary to ventricular tachyarrhythmia. Limiting symptoms (83%; of them 94% being dyspnea/fatigue correlating with severity at P less than 0.01) and complex ventricular arrhythmias as endpoints terminated 85% of the tests safely in this series. Atrial thrombuses (34%, all non-floating) did not cause any related complications. Thus, we concluded that limiting symptoms and complex ventricular arrhythmias are the proper endpoints in evaluating the exercise capacity of patients with mitral stenosis after prior echocardiographic exclusion of those with potentially risky floating thrombus.

Adolescent↗
PubMed2005

The prognostic value of a QRS score during exercise testing.

BACKGROUND: Values of a QRS score have been positively related to the number of narrowed coronary arteries and to the extent of myocardial ischemia in radionuclide imaging techniques. HYPOTHESIS: This study was conducted to evaluate the potential prognostic information of abnormal values of this QRS score during treadmill exercise testing in patients with established coronary artery disease (CAD). METHODS: In all, 309 patients (258 men, 51 women, mean age 56.1 +/- 10.0 years) with documented CAD, underwent a treadmill exercise test and coronary arteriography at baseline. Subsequently, they were prospectively followed to a maximum of 36 months (mean follow-up 23 +/- 13 months, median 25 months). RESULTS: During the follow-up period, 20 patients (6.5%) died from acute myocardial infarction. Abnormal QRS score values were found to be significantly and independently associated with cardiac mortality (QRS < or = -4: relative risk 11.7; 95% confidence interval = 2.5-55.4; p = 0.002). CONCLUSIONS: Taking into consideration the importance of exercise testing in the management of ischemic heart disease, the use of this QRS score could be of clinical value in predicting the outcome of patients with documented CAD.

Comorbidity↗
PubMedDate not supplied

[Hypokalemic periodic paralysis: exercise test].

INTRODUCTION: Periodic paralyses are illnesses related with the dysfunction of the ionic pathways of the muscle fibre membrane. Neurophysiological diagnosis by means of a conventional electromyogram (EMG) is rather unsatisfactory when exploring patients in the asymptomatic phase, since they often display unspecific changes. Furthermore, it does not identify the alterations in muscular excitability. The exercise test consists in determining the variation in the area or the amplitude of the muscular action potential, which is obtained through electrical stimuli that are repeated periodically for several minutes after having carried out local exercise with the explored muscles. It is a simple technique that enables us to achieve a significant reduction in the area or amplitude of the action potential (more than 40% or 50% with regard to the basal value) in certain diseases produced by ionic pathway dysfunction, while the patient is in the asymptomatic phase. CLINICAL CASES: We report the cases of three patients diagnosed as suffering from hypokalemic periodic paralysis. During the asymptomatic phase, the EMG revealed characteristic myopathic changes in only one case and unspecific alterations in the other two. Nevertheless, the exercise test that was also performed during the asymptomatic phase showed a characteristic pathological response in the three patients. CONCLUSION: The exercise test is a technique that indirectly shows up the progressive loss of muscle fibre membrane excitability and helps diagnosis in asymptomatic patients.

Action Potentials↗
PubMed2000

Feasibility and safety of early exercise testing using the Bruce protocol after acute myocardial infarction.

OBJECTIVE: To assess the feasibility and safety of exercise testing (ET) using a Bruce protocol (BPR) within three days of an acute myocardial infarction (AMI) with the data obtained from a prospectively managed database. BACKGROUND: Exercise testing after AMI is usually done between days 4 and 6 and often using a "low-level" protocol. Earlier testing with BPR may allow for efficient triage. METHODS: Patients were considered for early ET when off intravenous nitroglycerine with no rest angina, uncontrolled cardiac failure or arrhythmias. RESULTS: Of 300 consecutive AMI patients who underwent an ET, 216 (72.0%; M = 163, F = 53; age mean 59 +/- 0.8 SEM, range 34 to 83 years) had ET within three days of admission. There were 124 (57%) negative, 56 (26%) positive and 36 (17%) indeterminate tests. The maximum heart rate achieved was 116 +/- 1 beats/min (range 64 to 163), which was 72.2 +/- 0.8% of predicted maximum (86.6% on beta-adrenergic blocking agents at ET; exercise duration = 6.7 +/- 0.2 min). Reasons for termination: maximum effort-89 (41%); low-level test target (stage III/IV of BPR)-63 (29%); positive ST segment change-19 (9%); severe chest pain-12 (5.5%); reaching 90% predicted maximum heart rate-6 (3%); nonsustained ventricular tachycardia-1 (0.5%); other-26 (12%). Fourteen (6.5%) patients had minor complications (i.e., drop in systolic pressure, chest pain >5 min) with no cardiac arrests, AMIs or deaths. After the ET, 87 (40%) patients were discharged the same day, 73 (34%) the next day. CONCLUSIONS: The majority of ETs after an AMI can be done using the Bruce protocol within three days of admission with a very low incidence of complications. This can lead to early triage and potential cost savings.

Adult↗