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Stress ECG

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Old 22nd May 2013, 08:37
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Stress ECG

In order to be an SFE (I have no intention of flying in an aircraft again!) I need a Class one medical, and, being of a certain age, I need to do three three-minute sessions on the 'treadmill'.

Anyone know the speeds/gradients of these three sessions so that I can practise?
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Old 22nd May 2013, 10:07
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Bruce

There are many different protocols used, the most common 'Bruce' protocol. look it up on the net and it will give you the speed and slope.
cannot see the point of practising, it's the changes in the ECG trace that is important.
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Old 22nd May 2013, 11:12
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Finbarr= as has been mentioned you will follow the Bruce protocol which you can look up on the internet. At my recent stress ECG the treadmill got reasonably steep and at a very fast walking pace--enough to get me breathing fast and a bit hot. But has been mentioned its the ECG that matters
good luck
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Old 22nd May 2013, 15:25
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WPW - if you knew how unfit I was you would understand the need for practice! Googling 'Bruce Protocol' reveals a test of seven levels, total 21 minutes. Last time I did it there were only three three-minute sessions totalling nine minutes. Which three does the CAA use?
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Old 22nd May 2013, 16:07
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I have done lots of these. As you say its 3x3 but the main purpose is to raise your heart rate to a certain level then monitor your recovery rate.
I have been stopped at 7 minutes but my heart responded fairly normally (well for my heart) and then I have done the full nine minutes felt great but my heart didn't respond as it should have so grounded again!
Its the ECG they are watching not your fitness!!
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Old 27th May 2013, 19:20
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I've eventually found out. If anyone's interested, the gradients are:

10/12/14 degrees

And the speeds are:

2.7/4.0/5.4 kph
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Old 30th May 2013, 19:55
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Sounds like the earliest stages of the Bruce Test, which is a maximal exercise test. Surprised that is used due to the fact it is designed to take participants to exhaustion very quickly. Safer tests are Chester Step & Chester Treadmill, which are sub-maximal but very accurate at determining fitness level.

Any ideas why particularly the Bruce Test is used?
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Old 30th May 2013, 22:35
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The two friends I know, who were referred to a Stress ECGby their doc or the FAA, were on the treadmill for about 2 minutes when the cardiologist said, "please take a seat, I've seen enough". Then picked up the phone and scheduled an OR.

Point being, it doesn't take much "stress" to determine the health of one's heart.
In both cases they had little in the way of symptoms, some mild chest pains.

Last edited by galaxy flyer; 30th May 2013 at 22:37.
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Old 31st May 2013, 10:28
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Exercise ECG

I'm in my 70s and still walk long distances for pleasure, once or twice annually around 200 hilly miles in a fortnight.
When I was originally put on the Bruce protocol at LGW, I was asked just to continue until I'd had enough.
Used to get bored after 13/14 minutes by which time the ramp is steep and nearly trotting pace !

Once, a few years ago, it caught me out on the recovery phase (an occasional missed/weak beat or something) and they took my medical away.
After weeks of waiting and incurring a lot of expence, I had a CT scan which was suggested by my consultant but not then approved by the CAA, as apparently they had no one qualified to read it.
It thus had to be sent away and all that meant more weeks of waiting because of holidays etc.

After losing the whole of a Summer they said that actually there was nothing wrong; the heart/arteries etc were clear and totally healthy !

The situation now is that, courtesy new rules from EASA, I can now work with a Class 2 medical that, at the moment, doesn't require an Exercise ECG.
Maybe I can now recover the large amount I spent because of a possible misdiagnosis by a doc who works one day a week, now and again.
If I worked that infrequently as a pilot, I wouldn't feel that I was really on top of the job.

Surely, these days there must be a more satisfactory way of assessing the health of the heart and general fitness ? Oh, and btw, I still fly a fair amount of medium G aeros with no aches or pains ever. None of your 10-12G stuff though……...

Last edited by Sleeve Wing; 31st May 2013 at 10:40.
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Old 3rd Jun 2013, 12:34
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Bruce Protocol

There are actually 6 stages of the Bruce Protocol, but the usual CAA one is only the first 4. Stage 1 is 1.7mph with the gradient set at 10% Stage 2 is 2.5mph at 12%. Stage 3 is 3.4mph at 14%. Stage 4 is 4.2mph at 16%. I find that the main problem at stage 4 is discomfort in the legs, particularly if you're short and have to keep walking when you would normally be jogging. Having a daily brisk walk for a week or so beforehand can certainly help to make things more comfortable on the day.
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Old 3rd Jun 2013, 12:38
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Bruce protocol

Sorry - I should have pointed out that you do 3 minutes in each stage.
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Old 30th Jun 2013, 15:59
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Having been doing them for 20 years I recommend stopping at 9 mins as that satisfies CAA requirements. Don't do more if you don't have to.

I think train drivers do 9 mins as well as they are single operator
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Old 4th Jul 2013, 13:51
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Sleeve Wing - more power to your elbow...or should it be legs...or heart!!

The gold standard for CAD is the Angiogram. Nothing else comes close due to false positives / negatives et al. The specialised CAT scan you did (and it has to be a special one to check for CAD) is about third on the list of identifying CAD in my opinion, the nuclear stress test being second.
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