Each year, over 1 million Americans experience a nonfatal or fatal myocardial infarction or sudden death from coronary heart disease (CHD) [1]. Unfortunately, death or myocardial infarction is the first symptom in 55% of patients with coronary artery disease [2] and is usually due to dislodgement of a plaque causing acute coronary occlusion. However, about 30% of these patients present with ischemia and have concurrent chest pain. In these individuals, exercise treadmill testing is a practical and the most commonly performed test to identify or confirm the presence of latent coronary artery disease [2]. In addition, an abnormal test has been shown to have definite predictive value. It is well known that when symptoms of typical angina are present, coronary disease can be predicted with considerable reliability. Even when there is no history of pain, there is still a strong possibility of significant coronary disease in patients with specific risk factors. Also, the reliability of the test in asymptomatic patients is improved when testing patients with a higher prevalence of the disease.
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Harris, G.D., White, R.D. (2009). Performance of the Exercise Test. In: Evans, C.H., White, R.D. (eds) Exercise Stress Testing for Primary Care and Sports Medicine. Springer, New York, NY. https://doi.org/10.1007/978-0-387-76597-6_2
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