Positive Exercise Electrocardiogram Research Articles

Predictive accuracy of positive exercise electrocardiogram: Relation of heart rate at which ischemic response initially appears to presence of coronary artery disease

Predictive accuracy of positive exercise electrocardiogram: Relation of heart rate at which ischemic response initially appears to presence of coronary artery disease

Thallium-201 myocardial imaging in evaluation of asymptomatic individuals with ischaemic ST segment depression on exercise electrocardiogram.

Asymptomatic adults with normal physical examination, normal resting electrocardiogram, and normal routine laboratory evaluation who have a positive exercise electrocardiogram and abnormal exercise thallium-201 myocardial image have a very high probability of angiographically significant coronary artery disease. If, on the other hand, the exercise electrocardiogram is positive for "ischaemic" ST segment changes, but the exercise thallium image is normal, the probability for coronary disease is low. The exercise electrocardiogram combined with thallium-201 myocardial image are safe non-invasive methods which can be performed on an out-patient basis.

Value of Treadmill Exercise Testing in Patients With Complete Bundle Branch Block

Exercise electrocardiography and selective coronary arteriography was performed in 24 consecutive patients with complete bundle branch block. The criteria for a positive exercise electrocardiogram (E-ECG) were a 1 mm depression or elevation in the J point from the control state, as well as in the ST-segment measured at 0.04 seconds from the J point. Eleven of 12 patients with complete left bundle branch block had a positive E-ECG. Nine of them had normal coronary arteriograms, except one with less than 50% lesions in two arteries. Two patients had severe three-vessel disease. Only one patient had a true negative exercise test. No patient had a false negative test. Nine of 12 patients with complete right bundle branch block had a positive E-ECG. One of these 9 had minimal nonobstructive disease, while the other 8 had severe two- or three-vessel coronary artery disease. Three of the 12 right bundle branch block patients had a negative E-ECG. Two of them had a true negative exercise test, and one a false negative test. Because of a high incidence of probably false positive results, E-ECG appears to be unreliable in detecting coronary artery disease in patients with complete left bundle branch block. But it can provide useful information in the noninvasive evaluation of coronary artery disease in patients with complete right bundle branch block.

Thallium-201 stress myocardial scintigraphy: Application in asymptomatic patients with positive exercise electrocardiograms

Thallium-201 stress myocardial scintigraphy: Application in asymptomatic patients with positive exercise electrocardiograms

Trials with an adenosine analogue as antianginal medication

The potential antianginal effects of orally administered ethyl-adenosine-5-carboxylate hydrochloride (EACH) were assessed in 9 patients with stable angina pectoris who underwent two standardized exercise tests for 3 consecutive days. The first daily exercise performed after placebo revealed no daily variation. The second test was preceded by placebo, 26 mg EACH or 33 mg EACH administered in a double-blind fashion with the use of crossover design. After the completion of the study in the first 6 patients, the 33-mg dose of EACH had to be discontinued because 3 patients had severe angina and another one had nausea and diffuse numbness after this dose. In the remaining 3 patients a 6-mg dose of EACH was used instead of 33 mg, after which the study was terminated because no difference could be determined. EACH, 26-mg and 6-mg, had no significant effect on resting and exercise heart rate, on blood pressure, on onset or duration of angina and positive-exercise electrocardiogram, or on exercise duration. Our study revealed that EACH had no potential antianginal effect and that at a dosage of 33 mg it may induce angina.

Two-step electrocardiogram for chest pain reported on multiphasic screening

Among 264 consecutive persons (142 men, 122 women) greater than or equal to 35 years of age presenting for multiphasic screening examination, 85 (54 men, 31 women) reported chest pain. In most, the pain was not typical of coronary artery disease. The two-step exercise electrocardiogram (ECG) was positive (greater than or equal to 0.5-mm ischemic ST depression) in 21% of the patients who reported pain and in 19.5% of 66 randomly selected, similarly examined controls without chest pain (36 men, 30 women) (difference not significant). Females with positive ECGs (5-mm or 1-mm depression) predominated over males greater than or equal to 5:1 in the chest pain group and greater than 3:1 in controls. This study indicates that the routine two-step exercise ECG is not helpful in detecting ischemic heart disease in persons reporting chest pain during their multiphasic screening examination.

Atypical Angina Pectoris

A typical angina pectoris presents a diagnostic challenge. When results of classic diagnostic procedures are equivocal, the author suggests the following ancillary methods: carotid sinus test, positive exercise electrocardiogram, nitroglycerin vasodilator test, postexercise coronary sinus oxygen saturation, transcoronary circulation time, catecholamine studies, and evidence of excess lactate production. Coronary arteriography can locate the lesion causing coronary insufficiency, and with more extensive use may become a valuable diagnostic aid in atypical angina pectoris.

Clinical evaluation of the ballistocardiogram: II. Heart disease—Hypertension, angina pectoris, and myocardial infarction

1. 1. Analysis of ballistocardiographic tracings has been made in a group of 135 subjects with known cardiac disease. 2. 2. In the patients with essential hypertension and hypertensive heart disease, only 2 were found to have a completely normal ballistocardiogram at rest. 3. 3. Seventy-five per cent of the angina patients with negative resting electrocardiograms (and positive exercise electrocardiogram tests) showed abnormal ballistocardiographic patterns at rest. Of 5 angina patients with normal resting ballistocardiograms, the ballistocardiogram in 4 became abnormal only after exercise. 4. 4. The ballistocardiogram was abnormal at rest in over 92 per cent of the patients with previous myocardial infarction. 5. 5. Preliminary confirmatory evidence of the valuable aid of the ballistocardiogram in everyday clinical practice is presented.