[Diagnosis of coronary artery disease - part 2: Exercise electrocardiogram and myocardial perfusion scintigraphy].
The principle of exercise stress test and myocardial perfusions scintigraphy (MPS) is based on the detection of exercise-induced myocardial ischaemia by ECG and non-invasive assessment of myocardial perfusion respectively, MPS being the more sensitive method. The exercise stress test is the method of choice in patients with a normal resting ECG and good exercise tolerance, whereas MPS is a suitable test for patients with abnormal resting ECG and/or exercise intolerance. Stressors for MPS included exercise, pharmacological stress, or a combination. Both exercise stress test and MPS are suitable for the evaluation of patients with chest pain and intermediate pre-test probability of significant coronary artery disease. For patients with high pre-test probability, both tests are helpful for risk stratification. Neither test makes sense for the evaluation of patients with chest pain and low pre-test probability of significant coronary artery disease or unselected asymptomatic patients.
Baker IDI Heart and Diabetes Institute, Heart Center, Alfred Hospital, Melbourne, Victoria, Australien. micha.maeder@bluewin.ch
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D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002637:Chest Pain / Q000209:etiology; D003327:Coronary Disease / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D012307:Risk Factors