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.^1-3Nevertheless, 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.^6.7They 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