The diagnostic accuracy of exercise electrocardiography--a review

The cardiovascular "stress test," and particularly the graded treadmill exercise test, has gained wide acceptance as a diagnostic aid in searching for ischemic heart disease and as a prognostic indicator for those with known coronary artery disease. Controversies still exist, however, in its use in mass screening and in interpreting equivocal tests. A review of the use and value of electrocardiographic exercise testing is presented. Topics such as its use in asymptomatic individuals, the adjuvant use of clinical examination, and the examination of ancillary treadmill parameters are presented. No attempt is made to detail the very significant contributions of radionuclide scanning. The positive exercise electrocardiogram in the asymptomatic subject is discussed and guidelines for clinical management are offered.