Exercise testing problems in the diagnosis of coronary artery disease

Abstract

Problems associated with exercise testing will always require special consideration. Disease prevalence, analysis of multiple variables, lead selection and many factors influence the diagnostic power of the method. New information indicates that septal Q waves, R wave amplitude, and possibly QT intervals are of importance in the diagnosis of ischemia. The analysis of blood pressure and heart rate response also contribute to the predictive power. At times, the response to nitroglycerin and beta blockers will help in the analysis of ST changes. Also, the time of ST onset and offset are helpful. Although computer analysis of the ECG is becoming more common, special attention to the fiduciary points, especially the baseline, will help identify errors introduced by these machines.