Positive computer-generated exercise electrocardiogram

The use of computerized averaging of the electrocardiogram (ECG) during stress testing has facilitated the removal of motion artifacts and baseline shifts. However, this process can introduce errors, which may not be appreciated by medical directors. Such errors can lead to significant ST depression in the absence of coronary artery disease. Such false-positive tests may lead to anxiety in the applicant, delays in accepting the application and unnecessary additional testing. This case study illustrates a common pitfall associated with using only a computer-generated exercise ECG for risk assessment of a life insurance applicant.