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Cardiac Stress Tests

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This referral requires charity care.

This protocol covers all six types of cardiac stress tests, including all kinds of functional testing (EKG, nuclear, echocardiography) and all kinds of stress (treadmill exercise vs. pharmacologic).

The TS will work with the Chief TS and the Cardiology TS to determine what type of functional testing and cardiac stress is indicated for the patient, based on the:

Baseline EKG within last 6 months
Ability to walk/jog unassisted on a treadmill

Senior Clinician

Discuss the necessity of a cardiac stress test with the attending

If a cardiac stress test is necessary, do the following:

Add the referral to the ACT Referrals Spreadsheet, specifying what type of cardiac testing the patient requires.Look to see if the patient has had an EKG in the past 6 months; if not, order and perform one in clinic today (ask Labs TS for help, if necessary)Determine if the patient can safely walk/jog on a treadmill without assistance (convey this information to the Head TS)When signing out, inform the Head TS of the necessity of this referral

Teaching Senior

When the senior clinician informs you of this referral, ask about

Patient's most recent EKG findingsPatient's ability to walk/jog unassisted on a treadmill

Then, after clinic:

Email Chief TS, Cardiology TS, ACT Referrals Chair, and ACT Ambulatory Referrals Manager regarding the necessity of this referralAdd referral request into the ACT Referrals Spreadsheet Referrals Request tab and specify what kind of cardiac testing the patient needs.Include what the SC said about the EKG and exercise tolerance

You will use this data to recommend to the Chief TS and Cardiology TS the type of cardiac stress testing indicated: (EKG, echocardiography, or nuclear) + (treadmill or pharmacological).

The most common option is EKG + treadmill exercise.

Access to Care Team

Ask patient about his/her upcoming availability for test schedulingAmbulatory Referrals Manager will send email to Jessica Deleon (Jessica.deleon@mountsinai.org). Email should include: MRN, name, DOB, EMC ID/expiration date, test required, reason for referral, and any comments (e.g. patient’s availability)This referral requires charity care. If patient lacks active charity care, fill out the REAP referral form for the patient.

For questions, please reach out to the ACT Referrals Chair (see EHHOP Roster).

Cost

The cost depends on the type of test chosen, including the type of functional testing or imaging.

For EKG + treadmill, a patient with charity care level 1 usually will be asked to pay $10.
For a nuclear test + treadmill, the billed cost is ~$3,200 and the patient would have to pay $10.

Wait Time

Wait time for stress tests done under the study will vary depending on patient availability.

Wait time will vary depending on how long it takes to complete the charity care process. Stress tests can usually be scheduled within 1-3 weeks.

Contact Information

Cardiology Imaging (855) 674-3278

Patient Financial Services: First floor, 17 East 102nd street (CAM) 212-824-7280

For questions, please reach out to the Cardiology TS (see EHHOP Roster).