Duke Treadmill Score Calculator
Assess coronary artery disease risk using exercise stress testing
Exercise Stress Test Parameters
Total duration of exercise using standard Bruce protocol
Maximum ST depression or elevation in any lead (except aVR)
No chest pain or angina during exercise
Duke Treadmill Score Results
Low probability of significant coronary artery disease
Recommendation: Continue standard care and lifestyle modifications
Calculation Breakdown
Duke Score = Exercise Duration - (5 x ST Deviation) - (4 x Angina Index)
Duke Score = 8 - (5 x 0.6) - (4 x 0)
Duke Score = 8 - 3.0 - 0.0
Duke Score = 5
Clinical Example
Patient Case Study
Patient: Susan, 58-year-old female with chest pain
Exercise Duration: 8 minutes (Bruce protocol)
ST-Segment Deviation: 0.6 mm depression
Angina: No chest pain during exercise (TAI = 0)
Score Calculation
Duke Score = 8 - (5 x 0.6) - (4 x 0)
Duke Score = 8 - 3 - 0
Duke Score = 5
Interpretation: Low Risk (5-year survival: 99%)
Action: Continue standard care and lifestyle modifications
Risk Stratification
Low Risk (≥5)
5-year survival: 99%
Low probability of significant CAD
Intermediate Risk (-10 to +4)
5-year survival: 95%
Moderate probability of CAD
High Risk (<-10)
5-year survival: 79%
High probability of significant CAD
Formula Components
Exercise Duration
Total time exercised using Bruce protocol (minutes)
ST-Segment Deviation
Maximum ST depression or elevation in any lead except aVR (mm)
Treadmill Angina Index
0 = No angina
1 = Non-limiting angina
2 = Exercise-limiting angina
Bruce Protocol Stages
Each stage lasts 3 minutes
Medical Disclaimer
This calculator is for educational purposes only and should not replace professional medical advice. The Duke Treadmill Score must be interpreted by qualified healthcare professionals in the context of the patient's clinical presentation, medical history, and other diagnostic findings. Exercise stress testing should only be performed under medical supervision with appropriate emergency equipment available. Always consult with a cardiologist for proper interpretation and clinical decision-making.
Understanding Duke Treadmill Score
What is the Duke Treadmill Score?
The Duke Treadmill Score is a validated prognostic tool that combines exercise capacity, ST-segment changes, and angina symptoms to assess the risk of coronary artery disease and predict long-term survival in patients undergoing exercise stress testing.
Clinical Applications
- •Risk stratification of patients with suspected CAD
- •Prognostic assessment for long-term survival
- •Guide decisions for further cardiac testing
- •Treatment planning and follow-up strategies
Formula Components
Exercise Duration
Longer exercise duration indicates better cardiac fitness and lower risk
ST-Segment Deviation
Greater ST depression suggests more severe ischemia and higher risk
Angina Index
Exercise-limiting angina indicates more significant coronary disease
Coronary Artery Disease (CAD)
Risk Factors
- • Advanced age and male gender
- • Hypertension and diabetes
- • High cholesterol levels
- • Smoking and obesity
- • Physical inactivity
- • Family history of CAD
Symptoms
- • Chest pain or discomfort (angina)
- • Shortness of breath
- • Fatigue with exertion
- • Heart palpitations
- • Nausea or cold sweats
- • Pain in arms, neck, or jaw
Exercise Stress Testing
Indications
- • Chest pain evaluation
- • CAD risk assessment
- • Exercise capacity testing
- • Pre-operative evaluation
Contraindications
- • Unstable angina
- • Recent MI (<48 hours)
- • Severe aortic stenosis
- • Uncontrolled arrhythmias
End Points
- • Target heart rate achieved
- • Significant ST changes
- • Limiting symptoms
- • BP abnormalities