Abstract
Exercise testing remains one of the most useful noninvasive diagnostic tests for identification of the patient with coronary artery disease. Significant ST segment depression,1 chronotropic incompetence,2 hypotensive systolic blood pressure response,3 and angina at low workload4 have all been shown to be of diagnostic and prognostic value in patients with severe coronary artery disease. However, the sensitivity of these criteria varies considerably, and their diagnostic value can be further limited in the presence of LVH,5 electrocardiographic conduction abnormalities such as LBBB,6 arrhythmia such as atrial fibrillation,7 and in patients receiving medical therapy such as digitalis8 or beta adrenergic blockers.
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