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The Bruce protocol is a standardized diagnostic test used in the evaluation of cardiac function and physical fitness, developed by American cardiologist Robert A. Bruce. [1] According to the original Bruce protocol the patient walks on an uphill treadmill in a graded exercise test with electrodes on the chest to monitor.
A resting echocardiogram is obtained prior to stress. The ultrasound images obtained are similar to the ones obtained during a full surface echocardiogram, commonly referred to as transthoracic echocardiogram. The patient is subjected to stress in the form of exercise or chemically (often dobutamine). After the target heart rate is achieved ...
[exercise duration in minutes, by Bruce protocol] – [ 5 × (maximal ST elevation or depression, in millimeters)] – [4 × (treadmill angina index)] Angina index is zero if no pain occurs during the exercise, one if the pain is limited to the exercise period but the patient can continue the exercise ( typical angina ), and two if a pain is a ...
Before the development of the Bruce Protocol, there was no safe, standardized protocol that could be used to monitor cardiac function in exercising patients.Master's Two-Step Test was sometimes used, but it was too strenuous for many patients and inadequate for the assessment of respiratory and circulatory function during varying amounts of exercise.
Sonographer doing an echocardiogram of a child Echocardiogram in the parasternal long-axis view, showing a measurement of the heart's left ventricle. Health societies recommend the use of echocardiography for initial diagnosis when a change in the patient's clinical status occurs and when new data from an echocardiogram would result in the physician changing the patient's care. [7]
The advantage of a MUGA scan over an echocardiogram or an angiogram is its accuracy. An echocardiogram measures the shortening fraction of the ventricle and is limited by the user's ability. Furthermore, an angiogram is invasive and, often, more expensive. A MUGA scan provides a more accurate representation of cardiac ejection fraction. [1]
Myocardial perfusion imaging or scanning (also referred to as MPI or MPS) is a nuclear medicine procedure that illustrates the function of the heart muscle (). [1]It evaluates many heart conditions, such as coronary artery disease (CAD), [2] hypertrophic cardiomyopathy and heart wall motion abnormalities.
A transthoracic echocardiogram (TTE) is the most common type of echocardiogram, which is a still or moving image of the internal parts of the heart using ultrasound. In this case, the probe (or ultrasonic transducer ) is placed on the chest or abdomen of the subject to get various views of the heart.