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Beacuse of the risks involved with treadmill testing, we avoid it and
instead opt to have the patient perform toe raises.  If the patient is a
claudicator, toe raises will produce symtoms with less stress to the heart.

Legally, isn't a physician supposed to be present during treadmill testing
for cardiac evaluation?
Wouldn't you want to take the same precautions in the Vascular Lab setting?


>referring physician, I'm still not sure that alleviates the need for a
>release.  I don't currently have patients sign release forms, I just
>worry
>about it.
>  I  do know of a case where the patient said "no" to questioning about
>cardiac disease, indeed had no known history of any, he still arrested
>on the
>treadmill and died. In fact the only deaths I have ever heard of in
>Vascular
>Labs have been during treadmill exercise.
>  Interesting considering how we have rarely seen a thrombus float off
>during
>venous examination.  I've seen 2 and there have been 1 or 2 others in
>the
>last ten years here, all without associated symptoms curing the exam or
>later.
>Lee Nix
>________________________________________________________________________
>_______
>_
>From: mark kahn on Fri, Jun 27, 1997 1:55 PM
>Subject: Re: exercise testing
>To: [log in to unmask]
>
>
>>--- "Lee Nix@CARDIAC" wrote:
>>Does anyone routinely have patients sign a release before exercising
>patients
>>on the treadmill in a non-cardiac setting?
>>Lee Nix
>>--- end of quoted material ---
>>Good point.  We do not, but I think every vascular lab should ask the
>question,
>>"Do you have a history of heart disease?" before submitting a patient to
>>treadmill testing.  If there is ever any question, the referring physician
>>should be called prior to testing.
>>
>>Joe Zaweski
>
>
>Exercise testing is not necessarily a cardiac stress test.  In the
>vascular
>lab we are asking patients to reproduce the exercise that they perform
>in
>their every day activities. which is why they are being evaluated for
>claudication (presumably "disabling" claudication), rather than chest
>pain.
>
>In a cardiac stress test they are being asked to perform at a level they
>may not ordinariy perform at.
>
>In the vascular lab, asking whether they get chest pain when walking
>should
>suffice, but of course, when in doubt, ask the refering MD.
>
>Mark B. Kahn,MD
>TJUH, Phila.
>