Published Jul 1, 2009
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?
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%.
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.
What is the purpose of the stress test, if there's no sign of ischemia?
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.
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