Skip to main content

Exercise electrocardiogram testing and thallium scintigraphy

  • Chapter
Clinical Nuclear Medicine
  • 98 Accesses

Abstract

Since 1918 when electrocardiogram (ECG) changes were first described during an attack of angina (Bousfield) the exercise ECG has become the most commonly used non-invasive test to identify those patients with coronary artery disease. The purpose of the test is to determine whether the coronary circulation will allow an increased oxygen supply to the myocardium in response to increased demand during exercise as well as assessing the overall exercise capacity of the patient. Initial results from exercise ECG studies suggested an extremely accurate test which could clearly distinguish between those patients with normal arteries and those patients with coronary disease (Mason et al., 1967).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Baron, D. W. et al. (1980) Maximal 12 lead exercise testing for prediction of severity of coronary artery disease. Eur. J. Cardiol, 11, 259–67.

    PubMed  CAS  Google Scholar 

  • Berman, J. L. et al. (1980) Multiple lead QRS changes with exercise testing: diagnostic value and haemodynamic implications. Circulation, 61, 53–61.

    Article  PubMed  CAS  Google Scholar 

  • Bishop, N., Adlakha, M. L., Boyle, R. M. et al. (1987) The segment/heart rate relationship as an index of myocardial ischaemia. Int. J. Cardiol. 14, 281–93.

    Article  PubMed  CAS  Google Scholar 

  • Bonoris, P. E., Greenbergh, P. S., Castallanet, M. J. and Ellestad, M. M. (1978a) Significance of changes in R wave amplitude during treadmill stress testing: angiographic correlation. Am. J. Cardiol, 41, 846–51.

    Article  PubMed  CAS  Google Scholar 

  • Bonoris, P. E., Greenbergh, P. S., Christison, G. W. et al. (1978b) Evaluation of R wave amplitude changes versus ST segment depression in stress testing. Circulation, 57, 904–10.

    Article  PubMed  CAS  Google Scholar 

  • Bousfield, G. (1918) Angina pectoris: variations in electrocardiograms during paroxysm. Lancet, 195:457.

    Article  Google Scholar 

  • Bruce, R. A. (1971) Exercise testing of patients with coronary heart disease: principles and normal standards for evaluation. Ann. Clin. Res., 3, 323–32.

    PubMed  CAS  Google Scholar 

  • Bruce, R. A. (1974) Values and limitations of exercise electrocardiography. Circulation, 50, 1–3.

    Article  PubMed  CAS  Google Scholar 

  • Bruce, R. A. et al. (1980) Value of maximal exercise tests in risk assessment of primary coronary heart disease events in healthy men: 5 years experience of the Seattle Heart Watch study. Am. J. Cardiol, 46, 371–8.

    Article  PubMed  CAS  Google Scholar 

  • Chaitman, B. R. and Hanson, J. S. (1981) Comparative sensitivity and specificity of exercise electrocardiographic lead systems. Am. J. Cardiol, 47, 1335–49.

    Article  PubMed  CAS  Google Scholar 

  • Chaitman, B. R. et al. (1979) The importance of clinical subsets in interpreting maximal treadmill exercise test results: the role of multiple lead systems. Circulation, 59, 560–70.

    Article  PubMed  CAS  Google Scholar 

  • Diamond, G. A. (1986a) Monkey business. Am. J. Cardiol, 57, 471–5.

    Article  PubMed  CAS  Google Scholar 

  • Diamond, G. A. (1986b) Reverend Bayes’ silent majority: an alternative factor affecting sensitivity and specificity of exercise electrocardiography. Am. J. Cardiol, 57, 1175–80.

    Article  PubMed  CAS  Google Scholar 

  • Diamond, G. A. and Forrester, J. S. (1979) Analysis of probability as an aid in clinical diagnosis of coronary artery disease. N. Engl. J. Med., 300, 1350–8.

    Article  PubMed  CAS  Google Scholar 

  • Epstein, S. E. (1978) Value and limitations of the electrocardiographic response to exercise in the assessment of patients with coronary artery disease. Am. J. Cardiol., 42, 667–74.

    Article  PubMed  CAS  Google Scholar 

  • Epstein, S. E. (1980) Implications of probability analysis on the strategy used for non-invasive detection of coronary artery disease. Am. J. Cardiol., 46, 491–9.

    Article  PubMed  CAS  Google Scholar 

  • Epstein, S. E. et al. (1979) Strategy for evaluation and surgical treatment of the asymptomatic or mildly symptomatic patient with coronary artery disease. Am. J. Cardiol., 43 1015–25.

    Article  PubMed  CAS  Google Scholar 

  • Hamilton, G. W. (1979) Myocardial imaging with thallium-201: the controversy over its clinical usefulness in ischaemic heart disease. J. Nucl. Med., 20, 1201–5.

    PubMed  CAS  Google Scholar 

  • Hlatky, M. A., Pryor, D. B., Marrell, F. E. et al. (1984) Factors affecting sensitivity and specificity of exercise electrocardiography: multivariable analysis. Am. J. Med., 77, 64–71.

    Article  PubMed  CAS  Google Scholar 

  • Kligfield, P., Okin, P. M., Ameisen, O. and Borer, J. S. (1986) Evaluation of coronary artery disease by an improved method of exercise electrocardiography: the ST segment/heart rate slope. Am. Heart J., 112, 589–98.

    Article  PubMed  CAS  Google Scholar 

  • Marcomichelakis, J. et al. (1980) Exercise testing after beta blockade: improved specificity and predictive value in detecting coronary heart disease. Br. Heart J., 43, 252–61.

    Article  PubMed  CAS  Google Scholar 

  • Mason, R. E. et al. (1967) Multiple lead exercise electrocardiography: experiences in 107 normal subjects and 67 patients with angina pectoris and comparison with coronary cinearteriography in 84 patients. Circulation, 36, 517–25.

    Article  PubMed  CAS  Google Scholar 

  • Redwood, D. R. et al. (1976) Whither the ST segment during exercise. Circulation, 54, 703–6.

    Article  PubMed  CAS  Google Scholar 

  • Rojanski, A., Diamond, G. A., Forrester, J. S. et al. (1984) Alternative referent standards for cardiac normality. Ann. Intern Med., 101, 164–71.

    Article  Google Scholar 

  • Thwaites, B. C. (1986) Comparison of the ST/heart rate slope with the modified Bruce exercise test in the detection of coronary artery disease. Am. J. Cardiol., 57, 554–6.

    Article  PubMed  CAS  Google Scholar 

  • Uhl, G. S. and Hopkirk, A. C. (1979) Analysis of exercise induced R wave amplitude changes in detection of coronary artery disease in asymptomatic men with left bundle branch block. Am. J. Cardiol., 44, 1247–50.

    Article  PubMed  CAS  Google Scholar 

  • Weiner, D. A. et al. (1979) Correlations among history of angina, ST segment respone and prevalence of coronary artery disease in the coronary artery surgery study N. Engl. J. Med., 301, 230–5.

    Article  PubMed  CAS  Google Scholar 

  • Yiannikas, J. et al. (1981) Analysis of exercise induced changes in R wave amplitude in asymptomatic men with electrocardiographic SR-T changes at rest. Am. J. Cardiol., 47, 238–43.

    Article  PubMed  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1991 Springer Science+Business Media Dordrecht

About this chapter

Cite this chapter

Brennand-Roper, D.A. (1991). Exercise electrocardiogram testing and thallium scintigraphy. In: Maisey, M.N., Britton, K.E., Gilday, D.L. (eds) Clinical Nuclear Medicine. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-3358-4_2

Download citation

  • DOI: https://doi.org/10.1007/978-1-4899-3358-4_2

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-0-412-27900-3

  • Online ISBN: 978-1-4899-3358-4

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics