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enseignants",{"title":54,"url":55},{"title":57,"url":58},{"title":186,"group":48,"menu":187},"Produit",[188,189,190,191,192,193,194],{"title":38,"url":7},{"title":65,"url":66},{"title":68,"url":69},{"title":71,"url":72},{"title":74,"url":75},{"title":15,"url":77},{"title":195,"url":10},"Tarification",{"title":197,"group":48,"menu":198},"Mentions légales",[199,200,201,202,203],{"title":197,"url":84},{"title":86,"url":87},{"title":89,"url":90},{"title":92,"url":93},{"title":95,"url":96},{"title":205,"group":48,"menu":206},"Service client",[207,208,209],{"title":101,"url":102},{"title":104,"url":105},{"title":107,"url":108},{"content":211,"related":295,"meta":366,"internal":376},{"title":212,"leadIn":213,"category":214,"elements":217,"becomeAnExpert":252,"author":285,"readDuration":293,"readDurationFormatted":294},"How to tell if a stress ECG is positive or not","Get to know the basic criteria for identifying a \"positive\" stress test.",{"id":215,"name":216},1,"Course previews",[218,229,234,239,247],{"type":219,"data":220},"video",{"readDurationInSeconds":221,"video":222},252,{"platform":223,"name":224,"url":225,"size":226},"YouTube","How to tell if a stress ECG (EKG) is positive?","https:\u002F\u002Fwww.youtube.com\u002Fwatch?v=PS-ImG1Exk8",{"width":227,"height":228},200,113,{"type":230,"data":231},"free_text",{"readDurationInSeconds":232,"text":233},7.733333333333333,"\u003Cp>This video was taken from our \u003Ca href=\"\u002Fcourse\u002Fexercise-stress-ecg-essentials\">Exercise Stress ECG Essentials course\u003C\u002Fa>. By the end of this lesson, you will know and be able to use the basic criteria for identifying a \"positive\" stress test.\u003C\u002Fp>",{"type":230,"data":235},{"readDurationInSeconds":236,"title":237,"text":238},13.866666666666665,"Join Exercise Stress ECG Essentials now!","\u003Cp>This course covers all the essentials of exercise stress testing—what it is, when to do it, and how to do it. Along the way, we will discuss issues such as which mode of exercise to use (e.g., treadmill versus cycle ergometer), when it’s safe to continue and when to stop the test, how to deal with ECG artifacts, and how to describe test results.\u003C\u002Fp>",{"type":240,"data":241},"cta",{"readDurationInSeconds":242,"text":243,"buttonText":244,"buttonUrl":245,"teachIllustration":246},4,"Start the first chapter of our Exercise Stress ECG Essentials course for free","Start chapter 1 now","https:\u002F\u002Fwww.medmastery.com\u002Fuser\u002Fregister?target=%2Fcourses%2Fexercise-stress-ecg-essentials","https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F99f55efa-59fb-462d-9475-f13d6815a0ed",{"type":230,"data":248},{"readDurationInSeconds":249,"title":250,"text":251},114.13333333333333,"Video Transcript","\u003Cp dir=\"ltr\">\u003Cb id=\"docs-internal-guid-4814fc67-7fff-c0d6-87aa-89b15574c6f9\">[00:00:00] \u003C\u002Fb>So, we know now that our ST segment is really the key to seeing if there is myocardial ischemia during stress testing. So, here we have our ST segment and here we have our baseline isoelectric, when the baseline and the ST segment are on the same level. When we talk about change, we're looking for a significant change in the ST segment, from where it was in the standing pre-stress ECG. Greater than or equal to 1 mm, \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cb id=\"docs-internal-guid-4814fc67-7fff-c0d6-87aa-89b15574c6f9\">[00:00:30] \u003C\u002Fb>which is 0.1 mV, at standard calibration, is considered a significant change. So, we're talking about one little box if we're at standard calibration. So, here we have our baseline, PR segment. Here's our ST segment. Here, we're about 1.5 boxes, so this is significant. Greater than a millimeter, greater than or equal to a millimeter. This ST segment is basically flat, it's horizontal, so this is called horizontal ST segment depression. And other than this little hitch, here in the J point, \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cb id=\"docs-internal-guid-4814fc67-7fff-c0d6-87aa-89b15574c6f9\">[00:01:00] \u003C\u002Fb>it really wouldn't matter if we measure the ST segment, here or here or here, we're going to get the same amount of depression from baseline. So, that's your horizontal ST segment depression. On the other hand, sometimes our ST segment slopes down over time. Somewhere in here, we're going to our T wave. Here, we have it downsloping. This is what its called when it goes down, downsloping ST segment. And in this case, we're going to get a very different measurement if we measure the ST segment, here or here or here. So, we need some sort of guideline as to \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cb id=\"docs-internal-guid-4814fc67-7fff-c0d6-87aa-89b15574c6f9\">[00:01:30] \u003C\u002Fb>where we're going to measure our ST segment. Here's our baseline, PR segment. If I measure here, I might get a millimeter. If I measure here, I'm close to 2 mm, certainly over a millimeter and half the depression. So, if we have this downsloping ST-segment depression, we have to have some sort of standard to where we're going to measure the depression. The J point is where the QRS ends and the ST segment begins. A very common approach to this is to go 80 milliseconds, which is two little boxes, \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cb id=\"docs-internal-guid-4814fc67-7fff-c0d6-87aa-89b15574c6f9\">[00:02:00] \u003C\u002Fb>at standard calibration, after the J point. Some people will call that 80 milliseconds post QRS, it’s the same thing. So, we find our J point and we go over two little boxes. Now, here, our J point isn't right on the line, so we start wherever the J point is and we go two little boxes over, that would put us, here. And here, is where we'd measure ST-segment depression. Here's our J point. Sometimes, it's hard to see exactly where that is but this seems to be it. We go two boxes over, two small boxes. So, here, we're in the middle of the box \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cb id=\"docs-internal-guid-4814fc67-7fff-c0d6-87aa-89b15574c6f9\">[00:02:30] \u003C\u002Fb>this set should be one box, two boxes. Here's our measurement point, two little boxes, which is 80 milliseconds at standard calibration, 0.08 seconds after the J point. That's our measurement point before the ST depression. Sometimes, we have a nice flatline in terms of the ST segment, horizontal ST depression. Really wouldn't matter where we measured this, it would all be the same. Sometimes, we have a downsloping ST segment. We should describe it as such and we have to be careful where we measure there because we're going to get a different \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cb id=\"docs-internal-guid-4814fc67-7fff-c0d6-87aa-89b15574c6f9\">[00:03:00] \u003C\u002Fb>number. So, greater than or equal to a millimeter of ST depression is significant. We should describe whether it's horizontal or downsloping and it's typical to measure at 80 milliseconds, post J point. ST is the key for ischemia. How much change we see is important? We want to be as precise as we can in describing it. Greater than or equal to a millimeter is significant. Where did we measure this? Many people will use 80 milliseconds after the QRS, also known as 80 milliseconds after the J point.\u003C\u002Fp>",{"courses":253,"showAwardsBelow":48},[254,272],{"id":255,"isFreeCmeCourse":256,"title":257,"type":258,"specialization":259,"teachers":261,"cmeCredits":215,"teacherIllustration":246,"backgroundImage":263,"relativeUrl":264,"lastChanged":265,"created":266,"description":267,"relativeURL":264,"meta":268},3987,false,"Exercise Stress ECG Essentials","course",[260],"Cardiology",[262],"Christopher Dunbar, PhD MPH RCEP FACSM","https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F99f55efa-f9a9-4113-8055-fba776301241","\u002Fcourses\u002Fexercise-stress-ecg-essentials","1774891776","1503355272","This course covers all the essentials of exercise stress testing: what it is, when to do it, and how to do it. 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Practice the skills you learned in the Stress ECG Course in this workshop containing a carefully selected array of cases based on the typical challenges you would encounter when performing an exercise stress test.",{"cases":284},20,{"id":286,"name":262,"image":287,"profession":288,"relativeUrl":291,"specializations":292},3889,"https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F9c43cef1-f097-4b66-b008-262534915955",{"name":289,"description":290},"Kinesiology professor","Christopher is a Professor in the Department of Kinesiology at Brooklyn College of the City University of New York, USA.","\u002Fteachers\u002Fchristopher-dunbar-phd-mph-rcep-facsm",[260],144,"3m",[296,322,341],{"id":297,"title":298,"text":299,"image":300,"author":308,"path":316,"readDuration":317,"readDurationFormatted":294,"internal":318},1350,"How to Recognize INOCA (ANOCA) on an Exercise Stress Test ","Angina, abnormal stress test, clean coronaries—that's INOCA (or ANOCA), and it carries real risk. Learn to recognize and report it with exercise stress ECG.",{"alt":301,"title":302,"size":303,"location":305},"Illustration of the heart's coronary vasculature showing large coronary arteries and the extensive network of smaller vessels affected in INOCA (ischemia with nonobstructive coronary arteries).","",{"width":304,"height":304},1200,{"bucket":306,"key":307},"public-drupal-medmastery-assets-production","\u002F2026-05\u002FC17(1)_magazine image_0.png",{"id":309,"title":310,"relativeURL":311,"image":312,"professionLong":313,"profession":314,"weight":242},1563,"Franz Wiesbauer, MD MPH","\u002Fteachers\u002Ffranz-wiesbauer-md-mph","https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F9c43cef0-41ee-4005-9e4a-d8711c816401","Franz is the founder and CEO of Medmastery. He is an internist with a specialization in cardiology and a master’s in public health from Johns Hopkins University.",{"name":315},"Internist","\u002Fmagazine\u002Fexercise-stress-ecg-inoca",141,{"created":319,"updated":320,"published":321},1778115738,1778118425,1778118255,{"id":323,"title":324,"text":325,"image":326,"author":332,"path":334,"readDuration":335,"readDurationFormatted":336,"internal":337},1348,"Hyperlipidemia screening: who, when, & what to measure","Testing for hyperlipidemia can help you mitigate your patients' cardiovascular risk. Learn who to screen and when, which measures to request, and how to stratify risk.",{"alt":327,"title":302,"size":328,"location":330},"Lipid panel blood sample tubes used to test for hyperlipidemia in a laboratory setting",{"width":329,"height":329},600,{"bucket":306,"key":331},"\u002F2026-04\u002FC121_magazine image.png",{"id":309,"title":310,"relativeURL":311,"image":312,"professionLong":313,"profession":333,"weight":242},{"name":315},"\u002Fmagazine\u002Ftest-for-hyperlipidemia",246,"5m",{"created":338,"updated":339,"published":340},1777403036,1777572381,1777412421,{"id":342,"title":343,"text":344,"image":345,"author":350,"path":359,"readDuration":360,"readDurationFormatted":361,"internal":362},1347,"Outpatient care for COPD exacerbations","Most acute COPD exacerbations can be managed with outpatient treatment. Learn how to treat mild and moderate COPD exacerbations—and when to escalate care.",{"alt":346,"title":302,"size":347,"location":348},"Older patient using a handheld nebulizer to inhale bronchodilator medication during an acute COPD exacerbation",{"width":329,"height":329},{"bucket":306,"key":349},"\u002F2026-04\u002FC133(4)_ exacerbations_magazine image.png",{"id":351,"title":352,"relativeURL":353,"image":354,"professionLong":355,"profession":356,"weight":358},5365,"Siamak Moayedi, MD","\u002Fteachers\u002Fsiamak-moayedi-md","https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F9c43cf02-1064-4074-817b-0eb5de6ded74","Professor and Director of Medical Student Education, University of Maryland and Course Director, Essential and Critical Procedures, Emergency Medicine.",{"name":357},"Emergency medicine physician",1533,"\u002Fmagazine\u002Facute-copd-exacerbation-treatment",191,"4m",{"created":363,"updated":364,"published":365},1776705362,1776710540,1776710541,{"seo":367,"og":369},{"title":368,"description":213},"How to tell if a stress ECG is positive or not | Medmastery",{"title":368,"description":213,"image":370},{"alt":302,"title":302,"size":371,"location":374},{"width":372,"height":373},480,313,{"bucket":306,"key":375},"\u002Fmigrated-images\u002F170906-magazine.jpg",{"id":377,"created":378,"updated":379,"published":378},140,1504686782,1739472215]