[Methods in stress ECG]

In spite of the continuous development of methods of examination, the exercise ECG still retains its position in the palette of examination methods for ischaemic heart disease. The examination mostly employs a mechanical load on bicycle ergometer or a treadmill. In the changes in the ST segment (horizontal or descending regression of ST surpassing 1 mm, i.e. 0.1 mV, measured 60-80 ms from junction) is still considered as the most indicative ECG index. The detection rate of ischaemic changes is proportional to the number of used leads. Sensitivity of visually evaluated exercise ECG is in the rang of 54 to 66%, specificity is around 82%. The elevation of ST-segment in aVR and V1 leads during exercise is considered as a manifestation of ischaemia. The regions affected by myocardial infarction it may indicate an aneurysm or dyskinesis and is considered as a manifestation myocardial ischaemia and a marker of poor prognosis. An adequate heart rate is presently considered significant. Sensitivity of the test is increased by ECG registration up to 8 to 10 minutes of the recovery phase.