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Scenario: Your patient is a 73 year old female (height 5 feet 5 inches,
weight 150lbs) who takes Advair and Salbutamol daily to prevent and treat her
asthma attacks as well as Ramipril for HTN. She was diagnosed by echo with
moderate aortic stenosis 3 months ago. She comes into the cardiology department
for a treadmill stress test, Bruce protocol with nuclear imaging. Upon further
investigation, using the CHARM method, she reveals that starting about 2 weeks
ago, shortly after starting walking on an inclined level, she develops severe
shortness of breath, dizziness and needs to pause for few minutes.
What concerns might you have? What type of stress test, with imaging would
you use? Why would you not choose other options?