ACH Premium Plus Questionnaire

The purpose of the test
Exercise testing measures the performance and capacity of the heart, lungs and blood vessels. In many cases, the test is carried out to assist in making a diagnosis of coronary artery disease. Other uses of the test include evaluating a patient’s capacity to undertake certain physical activities, the planning of an appropriate training program. Before being tested you will have been questioned and examined by a Doctor and a resting electrocardiogram will be recorded prior to performing exercise.

Please note, if you have a diagnosed cardiac condition we recommend you have review with your cardiologist for appropriate management advice. The Doctor will do a risk assessment at your appointment and may suggest it is more appropriate to have your exercise testing/alternative testing or advice with your cardiologist.

Risks
Clinical exercise stress testing like any test, has certain risks. While every effort is made to minimize the risks of the procedure, there is a small but definite risk of complications which you should be aware of. Be aware also that emergency equipment and trained personnel are available to deal with any complications that may arise.

Serious potential complications include the possibility of a major disturbance of heart rhythm requiring resuscitation, the development of heart failure or prolonged angina (heart pain), or the development of a heart attack. The risk of one of these occurring is approximately 2 or 3 in 10,000 tests. Unfortunately, there is also a very small risk of death occurring as a result of an exercise test.

The chance of this in the average patient is approximately 1 in 10,000. The risks both of complications and of death may be higher in patients who are already known to have coronary disease hence why the risk assessment is carried out as detailed about and hence why in a higher risk individual testing is more appropriately carried out with a cardiologist to expedite any urgent procedures which could be required in the event of an emergency.

Testing procedure
Testing consists of walking on a treadmill and the speed and gradient of the treadmill will be increased every three minutes, or be performed on a bike whereby the resistance will increase every minute. The test is eventually stopped if and when you develop symptoms such as fatigue, breathlessness, tired legs, chest pain or other symptoms. Throughout the test a technician will be present and your pulse, blood pressure and electrocardiogram will be monitored. If there is any change in any of these observations, which concerns the technician, he or she may stop the test immediately. Your pulse, blood pressure and electrocardiogram will continue to be monitored for 5 minutes after the test has been stopped. If at any time during the test you are feeling unwell in any way, report the symptom immediately.

I understand the Exercise Stress Test is not designed to give prognostic information about my cardiovascular system (ie. It does not indicate what future risk of Cardiovascular disease is). I can discuss other tests in this regard with the Treating Doctor. I understand the purpose of the test is to identify significant coronary artery blockages (ie.70% or greater) and rhythm disturbances with exercise.

I understand no test is 100% accurate and there can be instances of False Positives with any test (ie. abnormalities detected which with further investigation are determined to be not significant) and False Negatives (ie. abnormalities not detected by the test). Whilst these are relatively low, I understand that in the instance of False Positives in particular, additional testing may need to be performed, potentially in conjunction with a Cardiologist and the costs incurred in this are my responsibility. I understand the Treating Doctor will contact me on the day of the exercise test to discuss this with me. I also understand the Exercise Test will be stopped if I complain of shortness of breath/chest pain/leg pain or fatigue or if any abnormalities of significance are detected whilst exercising.

I understand I may refuse to do the exercise test. I also understand it is my responsibility to inform the Treating Doctor of any cardiac/lung symptoms I may have been having prior to my Medical consultation and to inform staff of any symptoms I have during the test. I also understand that the test is performed at the discretion of the examining Doctor taking in to account my prior history and current medical conditions and the test may not be carried out on medical grounds.