title: Diagnostic exercise testing in 104 patients over 65 years of age.
abstract: Since 1979 we have carried out symptom limited exercise stress tests for the diagnosis of chest pain in 104 patients, 61 male, 43 female, over 65 years of age; mean age 68 +/- 3 years. An upright bicycle ergometer was used for 64 tests, a treadmill for 38 tests and a supervised walk for 2 patients unable to undergo formal exercise testing. A positive result of greater than or equal to 1 mm of ST depression was recorded in 45% of patients; males 57%, females 28% (P less than 0.01). Bicycle and treadmill tests were equally likely to produce a positive result; bicycle 43%, treadmill 50% (NS). The limiting symptom was chest pain in 43%, dyspnoea in 26% and fatigue in 30% of patients. No serious arrhythmias or collapses occurred. During a mean follow up to 24 +/- 18 months 13 patients died. A positive exercise test was associated with a significantly increased risk of cardiac death; 8 of 47 patients with positive tests died compared with 1 of 57 patients with negative or equivocal tests (P less than 0.02). The remaining 4 deaths were due to malignancy. Exercise testing can thus be safely performed in elderly subjects with the expectation of a high diagnostic yield. A positive result confers a poor prognosis.
mesh_terms: D000368:Aged; D003327:Coronary Disease / Q000175:diagnosis*; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain; D005082:Physical Exertion; D011379:Prognosis; D013909:Thorax