[New criteria for a positive exercise test].
In this paper, the author reviews the recently developed criteria for a positive stress test. The "nearly ischaemic" appearance in which the ST segment is depressed by greater than or equal to 1.5 mm and slowly rises (slope of less than or equal to 1 millivolt/second) to a value which is predictive in symptomatic patients, of 70 p. cent in favour of coronary artery disease and 40 p. cent in favour of multiple vessel disease. The increased amplitude of the R wave in V5 immediately after effort is more a sign of left ventricular dysfunction than of coronary artery disease. The decreased amplitude of the Q wave in V5 and V6 at maximal effort is a very sensitive (82%) and very specific (88%) sign of left coronary or anterior interventricular artery disease. Similarly, inversion of the U wave in V5 on effort is a very sensitive and specific (97%) sign of left coronary or anterior interventricular artery disease. The major value of these new criteria is to help recognise the false negative results of the stress test, which can be as high as 50% of cases in patients with one vessel disease.
D001145:Arrhythmias, Cardiac / Q000503:physiopathology*; D003327:Coronary Disease / Q000175:diagnosis / Q000503:physiopathology*; D005080:Exercise Test / Q000379:methods*; D006801:Humans
Les nouveaux critères de positivité de l'epreuve d'effort.