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Do not consume caffeine or caffeine-containing substances for 5 days prior to the stress test
24%
23/97
Stop taking aspirin 1 week prior to the stress test
6%
6/97
Stop taking amlodipine 2 days prior to the stress test
58%
56/97
Take double the normal dose of metformin and avoid eating the morning of the test
0%
0/97
Stop smoking 10 days before the stress test
11%
11/97
Select Answer to see Preferred Response
For patients without a history of coronary artery disease, medications including beta-blockers, calcium channel blockers (amlodipine), and nitrates should be stopped 48 hours before undergoing a cardiac stress test, as these agents affect the accuracy of stress testing. Such medications may cause a false negative by masking ischemic changes on the electrocardiogram or stress test imaging. Additionally, they may cause a false positive result by creating artificial ischemic changes on the electrocardiogram. Stopping these agents 48 hours prior to the stress test allows for 4-5 half-lives to pass, thereby reversing the hemodynamic effects of these medications. In contrast to the above patient, if a patient has a known history of coronary artery disease, their antianginal medications (nitrates, beta-blockers, and calcium channel blockers) should be continued to evaluate the efficacy of the patient's treatment regimen with exertion. Indications for stress testing can include pre-operative assessment, identification of the extent/existence of coronary artery disease, evaluation of the efficacy of current cardiac treatment, and identification of appropriate and safe levels of exercise. Incorrect Answers:Answer 1: Caffeine interferes with stress testing, but it is only necessary to withhold consumption for 24 hours before the test.Answer 2: Aspirin does not affect the quality of the results obtained from stress testing, and there is no need to hold this medication prior to the test.Answer 4: Increasing metformin and skipping a meal may trigger a hypoglycemic episode, particularly with the exertion involved in an exercise stress test.Answer 5: Although smoking cessation is always advised, for the purposes of the stress test, smoking should only be stopped on the day of the test to maintain accuracy.Bullet Summary:For patients without a history of coronary artery disease, medications like calcium channel blockers should be stopped 48 hours prior to a cardiac stress test to ensure accurate results.
4.7
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