Usefulness of the exercise electrocardiogram in diagnosing ischemic or coronary heart disease in patients with chest pain.
We compared exercise electrocardiograms with myocardial perfusion images and coronary angiograms in 186 patients who had been referred to coronary angiography for stable angina pectoris. All had normal electrocardiographic findings at rest, and none had undergone coronary revascularization. Sensitivity, specificity, and positive and negative predictive values with the exercise electrocardiogram for prediction of reversible and/or irreversible hypoperfusion were 58%, 89%, 76%, and 77% and 70%, 88%, 72%, and 87%, respectively, for prediction of reversibility only. Corresponding values for comparison with coronary angiography were 65%, 89%, 74%, and 83%, respectively. Sensitivities were considerably lower in women than in men. Exercise electrocardiographic findings were normal in 50% of women and 25% of men who had reversible perfusion defects.
Høilund-Carlsen
Poul Flemming
PF
Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark. pfhc@ouh.fyns-amt.dk <pfhc@ouh.fyns-amt.dk>
Johansen
Allan
A
Christensen
Henrik Wulff
HW
Pedersen
Lise Tøffner
LT
Jøhnk
Ida Karina
IK
Vach
Werner
W
Haghfelt
Torben
T
D002637:Chest Pain / Q000175:diagnosis / Q000209:etiology*; D003327:Coronary Disease / Q000150:complications / Q000175:diagnosis; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications / Q000175:diagnosis*; D011446:Prospective Studies