Exercise ECG Screening
Why is this important?
- The risk of cardiovascular events increases as a direct function of:
- Exercise intensity from Low to Moderate to Vigorous:
- Low intensity exercise: <40% V02 max or aerobic capacity max
- Moderate intensity exercise: 40-60% of VO2 max; 3-6 METs; intensity well within the individual’s capacity and can be comfortably sustained for a prolonged period of time (~45 minutes).
- Vigorous intensity exercise: >60% of VO2 max; >6 METs; intense enough to represent a substantial cardiorespiratory challenge.
- Presence of 2 or more risk factors that predict exercise-induced cardiovascular events.
- Age (male >45, female >55 yrs)
- Family History (MI, Fam Hx CABG, SCD father <55 yrs or mother <65 yrs)
- Cigarette smoking (current or previous 6 mos)
- Sedentary lifestyle (no 30 minutes of moderate PA, 3x/wk for at least 3 mos)
- Obesity (BMI >30)
- Hypertension (>140/90)
- Dyslipidemia (LDL >130, HDL <40)
- Prediabetes (IFT or IGT)
- American College of Sports Medicine (ACSM) has recommendations on when a medical examination and exercise ECG test is needed.
When to consider exercise ECG testing?
- High-risk individuals engaged in moderate or vigorous exercise.
- Moderate-risk individuals engaged in vigorous exercise.
- Not needed for low-risk individuals involved in low to moderate levels of exercise.
- Keep in mind this may be useful in establishing a safe and effective exercise prescription for these individuals.
- Can help rule out electrocardiographic abnormalities and other associated CVD symptoms.
- The ACSM testing recommendations and exercise related cardiovascular risk factors are summarized in the Decision Tree Figure [PDF - 43KB]