[Exercise test in coronary insufficiency diagnosis]

If the anamnesis is not conclusive for a definite diagnosis of angina pectoris or if a complementary test is adviseable the ECG, which is hardly ever significant at rest, can become very significant under the influence of physical activity. The easiest methodology is a bicycle ergometer or a treadmill performance test which can be performed under ideal safety conditions and which gives the best possible information. Compared to the coronarography results in 319 patients, the performance test at either maximum heart rate or up to the appearance of the typical electrocardiographic alterations was positive in 75.5% of the cases. It is less instructive if the test is not systematically exhaustive. Its validity also varies depending on the number of coronary arteries affected by stenosis, on the type of the angina pectoris, and the aspect of the ECG at rest. If the test is performed up to the maximum heart rate, its sensitivity is superior to the ones using lsoprenaline or right atrial pacing as a means for influencing the ventricular function.