Congestive heart failure exercise stress testing

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Congestive Heart Failure Microchapters


Patient Information


Historical Perspective



Systolic Dysfunction
Diastolic Dysfunction


Differentiating Congestive heart failure from other Diseases

Epidemiology and Demographics

Risk Factors


Natural History, Complications and Prognosis


Clinical Assessment

History and Symptoms

Physical Examination

Laboratory Findings


Chest X Ray

Cardiac MRI


Exercise Stress Test

Myocardial Viability Studies

Cardiac Catheterization

Other Imaging Studies

Other Diagnostic Studies


Invasive Hemodynamic Monitoring

Medical Therapy:

Acute Pharmacotherapy
Chronic Pharmacotherapy in HFpEF
Chronic Pharmacotherapy in HFrEF
ACE Inhibitors
Angiotensin receptor blockers
Aldosterone Antagonists
Beta Blockers
Ca Channel Blockers
Positive Inotropics
Angiotensin Receptor-Neprilysin Inhibitor
Antiarrhythmic Drugs
Nutritional Supplements
Hormonal Therapies
Drugs to Avoid
Drug Interactions
Treatment of underlying causes
Associated conditions

Exercise Training

Surgical Therapy:

Biventricular Pacing or Cardiac Resynchronization Therapy (CRT)
Implantation of Intracardiac Defibrillator
Cardiac Surgery
Left Ventricular Assist Devices (LVADs)
Cardiac Transplantation

ACC/AHA Guideline Recommendations

Initial and Serial Evaluation of the HF Patient
Hospitalized Patient
Patients With a Prior MI
Sudden Cardiac Death Prevention
Surgical/Percutaneous/Transcather Interventional Treatments of HF
Patients at high risk for developing heart failure (Stage A)
Patients with cardiac structural abnormalities or remodeling who have not developed heart failure symptoms (Stage B)
Patients with current or prior symptoms of heart failure (Stage C)
Patients with refractory end-stage heart failure (Stage D)
Coordinating Care for Patients With Chronic HF
Quality Metrics/Performance Measures

Implementation of Practice Guidelines

Congestive heart failure end-of-life considerations

Specific Groups:

Special Populations
Patients who have concomitant disorders
Obstructive Sleep Apnea in the Patient with CHF
NSTEMI with Heart Failure and Cardiogenic Shock

Congestive heart failure exercise stress testing On the Web

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Risk calculators and risk factors for Congestive heart failure exercise stress testing

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Sara Zand, M.D.[2] Lakshmi Gopalakrishnan, M.B.B.S. [3] Edzel Lorraine Co, DMD, MD[4]


Exercise stress testing with an assessment of oxygen consumption is useful in assessing the functional capacity of the heart failure patient. Cardiopulmonary exercise testing is considered to optimize prescription of exercise training.

Exercise Stress Testing

Exercise stress testing is useful in measuring the functional capacity of heart failure patients. It is also helpful to assess the efficacy of congestive heart failure treatment.

2021 European Society of Cardiology Guidelines (DO NOT EDIT) [1]

Class I
" Cardiopulmonary exercise testing is recommended as a part of the evaluation for heart transplantation and /or mechanical circulatory support. (Level of Evidence: C) "
Class IIa
"Cardiopulmonary exercise testing should be considered to optimize prescription of exercise training. (Level of Evidence: C) "
" Cardiopulmonary exercise testing should be considered to identify the cause of unexplained dyspnea and/or exercise intolerance.(Level of Evidence: C) "

Exercise and Functional Capacity Testing 2022 AHA/ACC/HFSA Heart Failure Guideline (DO NOT EDIT) [2]

Class I
"1. In patients with HF, assessment and documentation of NYHA functional classification are recommended to determine eligibility for treatments. [3][4] (Level of Evidence: C-LD) "
"2. In selected ambulatory patients with HF, cardiopulmonary exercise testing (CPET) is recommended to determine appropriateness of advanced treatments (eg, LVAD, heart transplant). [5][6][7][8][9](Level of Evidence: C-LD) "
Class IIa
"3. In ambulatory patients with HF, performing a CPET or 6-minute walk test is reasonable to assess functional capacity. [5][6][10][11][12][13][14][15][16][17] (Level of Evidence: C-LD) "
"4. In ambulatory patients with unexplained dyspnea, CPET is reasonable to evaluate the cause of dyspnea. [18][19](Level of Evidence: C-LD) "

Class IIb
"7. In patients with HF and coronary artery disease (CAD) who are candidates for coronary revascularization, noninvasive stress imaging (stress echocardiography, single-photon emission CT [SPECT], CMR, or positron emission tomography [PET] may be considered for detection of myocardial ischemia to help guide coronary revascularization. [20][21][22][23][24] (Level of Evidence:B-NR) "

External Links


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