Utility of exercise ECG testing in clinical practice: back to the future?

Assessment of patients presenting for the first time with suspected coronary artery disease (CAD) remains cumbersome with multiple diagnostic options. Likelihood of CAD can be estimated based on symptoms and risk factors, and an abnormal ECG may also be helpful. Patients with moderate/high probability of CAD are usually referred for further tests including angiography (CT or invasive) or isotope-based myocardial perfusion scans.1 2 The exercise ECG, once the stalwart of chest pain evaluation, has lost favour over the last two decades in most heart centres due to its relatively poor discriminatory ability and reliance on patients to walk on a treadmill.1 2 The steady thump of patients’ feet on the treadmill has instead been replaced by scanner-based technologies. Invasive coronary angiography as a first-line test tends to be reserved for patients with high probability of CAD (typical angina symptoms with risk...
Source: Heart - Category: Cardiology Authors: Tags: Editorials Source Type: research