Indications for Electrocardiographic Exercise Testing in the Detection of Ischemic Myocardium
When done properly, i.e. obeying established contraindications and indications for stopping the test, exercise testing is a remarkable safe procedure. In extensive multi-center experience mortality has ranged from 0.005% to 0.01% and morbidity in terms of arrhythmias and prolonged chest pain necessitating hospitalization, from 0.04%–0.08% [7, 19]. The author’s personal experience over the last 10 years covers some 500 tests with two cases of transient pathologic Q-waves (0.04%). Despite this, safety indications for exercise testing in the detection of ischemic myocardium should be clearly defined. This is essential both in terms of cost/benefit and to avoid vague information. Economical aspects are not crucial in the cost/benefit analysis, but the manpower involved is considerable since maximal testing should not be performed without an attending physician. Equivocal information from indiscriminant use of exercise testing is distressing for the physician and test subjects alike.
KeywordsExercise Testing Exercise Tolerance Variant Angina Pretest Likelihood Physical Training Program
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