Exercise Electrocardiography in Women with Suspected Coronary Disease
Exercise testing is a commonly used tool for the evaluation of atherosclerotic coronary artery disease. ST-segment depression has been a focus of interest as a marker of ischemia since at least 1928 (1). As early as 1950. Scherlis et al noted that, compared to men, normal women were more likely to have ST-segment abnormalities after exercise (2). Since then, most (if not all) studies have indicated a higher false-positive rate for ST-segment changes in women compared with men. From this body of literature emphasizing the higher false-positive rate comes the current perception that exercise electrocardiography is inherently less useful in women compared with men. The following review will examine recent developments in the accuracy of the exercise test in women, the role of hormones in the false-positive response, and the role of exercise testing in the evaluation of women with symptoms of suspected coronary disease.
KeywordsCoronary Disease Estrogen Replacement Therapy Pretest Probability Referral Bias Pretest Score
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