Question

During an incremental maximal exercise test what would a normal response be to HR, SBP, DBP, Ventilation, EKG. Also, what would an abnormal response be for each?

Answer 1

During incremental exercise test , the normal responses would be -

On Heart Rate :

The formula for heart rate at incremental exercise test is 220 beats per minute minus the age. For example: for 50 year old, it would be 170 bpm.

On Systolic blood pressure :

Systolic blood pressure can increase upto 180 mm of Hg from 120 mm of Hg and would take 20 to 30 minutes to return to normal.

Diastolic blood pressure:

There is only minimal change in diastolic blood pressure ranging above to 10mm of Hg . Normal DBP is 80 mm of Hg.

Ventilation :

There is increased oxygen uptake resulting in increased respiratory rate which can go upto 50 breaths per minute.

On ECG :

During exercise, there is change in endocardial action potentials during both systolic and diastole which results in elevation in TQ segment in ECG.

Abnormal response to incremental exercise test:

Heart rate :

If there is increment in Heart rate between 40 to 100 % of workload , it indicates cardiovascular diseases.

SBP :

Increase in systolic blood pressure above 180 mm Hg shows cardiovascular issues and hypertrophic cardiac sympathy has to be ruled out.

DBP :

Increased DBP above 100 mm of Hg can be life threatening. Coronary artery disease could be a reason and further investigations has to be done.

Ventilation:

There may be dyspnea or difficulty in breathing along with tachypnea as abnormal response to incremental exercise test.

On ECG :

There would be disturbances in rhythm and conduction causing ST segment and T wave disturbances. ST segment depression would be a common change in ECG.

These were normal and abnormal changes in response to incremental exercise test.

Thank you..