stress testing & imaging findings associated with poor prognosis

Introduction

Indicators of poor prognosis:

• angina or ischemic ST response
  • < 6 METS (Bruce protocol)
  • heart rate < 120/min
  • double product < 200
• 2mm or greater ST segment depression with normal resting ECG
• any ST segment elevation with normal resting ECG
• ST segment depression peristing more than 6 minutes into recovery
• exercise-induced hypotension
• exercise-induced ventricular couplets with ST segment depression or ventricular tachycardia
• reversible wall motion or perfusion defects in a large area involving distribution of 2 or more coronary arteries
• resting left ventricular ejection fraction of <45%
• increased lung/heart uptake of Th-201 planar imaging