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Q. What do you mean by Recovery Period?
At the instant exercise is discontinued, the ECG recorded is turned on and left running for a few seconds while the blood pressure is recorded and the patient lies down. The evaluation of the ST-segments and other ECG changes in the first few seconds is often very important occasionally a more stable baseline can be obtained by asking the patient to hold his or her breath for a few seconds. Blood pressure is often low at the period just after the exercise, only to rise temporarily again about one minute later. This drop in blood pressure may be due to the temporary inadequacy in cardiac pumping capacity in relation to metabolic demand, or it may be due to the vasodilatation associated with increasing the lactic acid concentrations at peak stress. The blood pressure and ECG are then recorded at 1 minute intervals for 6 minutes while the patient is supine.
It is common for the ECG pattern to be equivocal immediately after exercise. If this is so, elevating the patients legs will increase the venous return at a time when the ventricular compliance is most likely to be reduced and the peripheral resistance is still elevated. This may result in an increased left ventricular end diastolic pressure (LVEDP) and a resistant increase in ST-segment depression. The decrease in heart rate from that maximally achieved to 1 minute into recovery should be noted. Late ST-segment depression and T-wave inversion should also be noted as well as the absence or presence of arrhythmias. Patients should be monitored until the ECG has returned to baseline.
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