A Phase II cardiac rehab patient with a history of MI/PCI experiences discomfort during exercise with an indeterminate single lead ECG. What is the appropriate next step?

Obtaining a 12-lead ECG is the most appropriate next step when a patient experiences discomfort during exercise and presents with an indeterminate single lead ECG. This is essential for several reasons.

First, a 12-lead ECG provides a comprehensive view of the heart's electrical activity from multiple angles, which can help identify any ischemic changes or arrhythmias that may not be visible on a single lead ECG. This is particularly important for a Phase II cardiac rehab patient with a history of myocardial infarction (MI) or percutaneous coronary intervention (PCI), as they are potentially at higher risk for cardiac complications during exercise.

Second, any discomfort during exercise in such patients warrants further investigation before any adjustments to the exercise protocol are made. By obtaining a 12-lead ECG, clinicians can make informed decisions based on accurate data regarding the patient's cardiac status. It's critical to ensure patient safety, and this step is vital to rule out any serious cardiac events.

Taking additional medications or increasing exercise intensity without first assessing the cause of the discomfort could lead to worsening of the patient's condition. Advising the patient to rest at home would also be inappropriate as it does not address the immediate concern of discomfort during exercise and neglects ongoing monitoring of the patient's cardiac health