Stress Testing / A fib

[Iamoverworked]

How safe is it for a patient with atrial fib (rate in 80's) with pulmonary emboli to have a stress test?

Thanks in advance for your responses.

[ghillbert, MSN, NP]

How long is a piece of string? As with everything, it's a balance of risk versus benefit. The AF is rate controlled. Is the patient anticoagulated? History of PE, or current PE? Why are they doing the stress test?

[Iamoverworked]

The patient was on a heparin drip, now on coumadin. PE is newly diagnosed. No history of prior PE or DVT.

Negative cardiac enzymes, and no chest pain. Ejection Fraction is 30%.

[dianah, ASN]

Agree w/ghillbert's observation: risk VS benefit.

You said pt has no c/o CP?

New onset CHF?

Has the EF changed recently?

Increasing or new onset SOB/DOE? (depends how big the PE is/was, how much lung is affected?) -- are they trying to sort out why the pt is still SOB, even after initiating PE tx?

Or is the question one of eval exercise capacity/response?

So many unknowns here.

[ghillbert, MSN, NP]

What is the purpose of the stress test, if there's no sign of ischemia?

[PageRespiratory!]

2 sets of negative enzymes, chest pain free, and controlled AF on anticoagulants.........I often see Pt's like this for a stress test. What kind of test is ordered? SOB would be my initial concern during the test, unless the PE has resolved.