In a group of clinically normal male executives subjected to maximal treadmill stress testing, the occurrence of ischemic st segment responses was in all cases unaccompanied by pain, while in a clinically suspect group a large proportion of those having ischemic st segment responses did not have chest pain. While a significant number of persons have no subjective sensation of pain while having ischemic st segment changes on the electrocardiograph during or after maximal treadmill exercise, occasionally atypical pain may occur during or following exercise. Maximal treadmill stress testing is useful in discovering "silent" coronary artery disease.

Adolescent↗

PubMed1967

Telemetry in monitoring stress electrocardiograms.

Explore the source record for details and available documents.

Electrocardiography↗

PubMed1967

The current application of maximal treadmill stress testing.

Treadmill stress testing has many applications in the overall evaluation of ischemic heart disease, both as a diagnostic aid and as an aid in serially following patients under study. Its use in the evaluation of procedures designed to improve myocardial function and coronary perfusion is of great value, for it can supply objective evidence without recourse to more difficult procedures such as determination of blood lactate levels. Ancillary procedures which may complement treadmill stress testing may prove to be valuable additions to the study of ischemic heart disease. The reported high rate of false-positive Master two-step tests would tend to make the treadmill exercise test more attractive.

Adult↗

PubMedDate not supplied

Stress testing: clinical application and predictive capacity.

Explore the source record for details and available documents.

Angina Pectoris↗

PubMedDate not supplied

Time course of changes in P-wave duration during exercise.

The exercise-induced increase in P-wave duration reported previously has not been studied on a minute-by-minute basis. We measured the P duration in 47 normal subjects and 43 coronary artery disease (CAD) patients each minute during an exercise test. We found that prolongation of the P wave in those with CAD occurs relatively early and the difference between normal subjects and CAD patients is greater near maximum exercise. The data suggest that an increase in P-wave duration may reflect an increase in the left-ventricular end-diastolic pressure and may occur earlier that ST-segment depression.

Coronary Disease↗

PubMedDate not supplied

Clinical assessment of the probability of coronary artery disease: judgmental bias from personal knowledge.

Probability estimates of angiographic coronary artery disease made by experienced, board-certified staff cardiologists were compared with those of cardiologists in training (fellows). In addition, estimates made before coronary angiography were compared with those made several months later based on written clinical summaries of 15 items of objective clinical and test data. Cardiologists were asked to estimate the probabilities of coronary artery disease, multivessel disease, and triple-vessel or left main disease. The study population consisted of 510 consecutive patients without valvular disease referred for the first time for coronary angiography to three hospitals. Both staff and fellows consistently overestimated the pre-angiographic probability of coronary artery disease. The probabilities estimated from patient summaries were always significantly lower than the pre-angiographic assessments. Only staff cardiologists reliably assessed the probabilities of coronary artery disease during the second assessment (p less than 0.05). Thus, estimates of disease probability based on clinical judgment vary according to the source of information, and these estimates are more accurate when physicians have objective data on hand and do not know the identities of the patients.

Coronary Angiography↗