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Exercise ECG Testing

Exercise ECG Testing Abstract Recently, the limitations of the exercise (stress) ECG test in the diagnosis of coronary artery disease (CAD) have been overemphasized, particularly in the asymptomatic population.1-3 Nevertheless, many physicians who have extensive and clinical investigative experience with the exercise ECG test are fully convinced that the test provides great value in the diagnosis of CAD and in the assessment of functional capacity.4.5 Some physicians who are skeptical about the value of the exercise ECG test for the screening of presumably healthy individuals are constantly disturbed by the high incidence (35% to 36%) of "false"-positive tests—ST segment responses.6.7 They criticize that a false-positive exercise ECG test frequently leads to psychological trauma (production of "cardiac neurosis") for the individual who has no CAD. It should be emphasized, however, that psychological trauma is usually physician-induced and by no means test-induced. The psychological reaction will largely depend on the physician's approach to a given individual References 1. Weiner DA, Ryan TJ, McCabe CH, et al: Exercise stress testing: Correlations among history of angina, ST-segment response and prevalence of coronary-artery disease in the coronary artery surgery study (CASS) . N Engl J Med 301:230-235, 1979.Crossref 2. Epstein SE: Limitations of electrocardiographic exercise testing . N Engl J Med 301:264-265, 1979.Crossref 3. Jones RJ: Bayes' theorem, the exercise ECG, and coronary artery disease . JAMA 242:1067-1068, 1979.Crossref 4. Chung EK: Exercise Electrocardiography: Practical Approach . Baltimore, Williams & Wilkins Co, 1979. 5. Morris SN, McHenry PL: Role of exercise stress testing in healthy subjects and patients with coronary heart disease: Controversies in cardiology—I . Am J Cardiol 42:659-666, 1978.Crossref 6. Epstein SE: Value and limitations of the electrocardiographic response to exercise in the assessment of patients with coronary artery disease: Controversies in cardiology-II . Am J Cardiol 42:667-674, 1978.Crossref 7. Redwood DR, Borer JS, Epstein SE: Whither the ST segment during exercise? Circulation 54:703-706, 1976.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Exercise ECG Testing

Chung, Edward K.
Archives of Internal Medicine , Volume 140 (7) – Jul 1, 1980
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References (8)

Publisher
American Medical Association
Copyright
Copyright © 1980 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1980.00040020895003
Publisher site
See Article on Publisher Site

Abstract

Abstract Recently, the limitations of the exercise (stress) ECG test in the diagnosis of coronary artery disease (CAD) have been overemphasized, particularly in the asymptomatic population.1-3 Nevertheless, many physicians who have extensive and clinical investigative experience with the exercise ECG test are fully convinced that the test provides great value in the diagnosis of CAD and in the assessment of functional capacity.4.5 Some physicians who are skeptical about the value of the exercise ECG test for the screening of presumably healthy individuals are constantly disturbed by the high incidence (35% to 36%) of "false"-positive tests—ST segment responses.6.7 They criticize that a false-positive exercise ECG test frequently leads to psychological trauma (production of "cardiac neurosis") for the individual who has no CAD. It should be emphasized, however, that psychological trauma is usually physician-induced and by no means test-induced. The psychological reaction will largely depend on the physician's approach to a given individual References 1. Weiner DA, Ryan TJ, McCabe CH, et al: Exercise stress testing: Correlations among history of angina, ST-segment response and prevalence of coronary-artery disease in the coronary artery surgery study (CASS) . N Engl J Med 301:230-235, 1979.Crossref 2. Epstein SE: Limitations of electrocardiographic exercise testing . N Engl J Med 301:264-265, 1979.Crossref 3. Jones RJ: Bayes' theorem, the exercise ECG, and coronary artery disease . JAMA 242:1067-1068, 1979.Crossref 4. Chung EK: Exercise Electrocardiography: Practical Approach . Baltimore, Williams & Wilkins Co, 1979. 5. Morris SN, McHenry PL: Role of exercise stress testing in healthy subjects and patients with coronary heart disease: Controversies in cardiology—I . Am J Cardiol 42:659-666, 1978.Crossref 6. Epstein SE: Value and limitations of the electrocardiographic response to exercise in the assessment of patients with coronary artery disease: Controversies in cardiology-II . Am J Cardiol 42:667-674, 1978.Crossref 7. Redwood DR, Borer JS, Epstein SE: Whither the ST segment during exercise? Circulation 54:703-706, 1976.Crossref

Journal

Archives of Internal Medicine – American Medical Association

Published: Jul 1, 1980

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