Status of exercise stress testing after myocardial infarction

The use and current limitations of early exercise testing of the patient with a postmyocardial infarction (MI) is reviewed. The test provides useful information in identifying patients at high risk of a second coronary event, thereby helping direct possible interventional therapy. It also furnishes information regarding the patient's capacity for physical exertion, detection of ventricular arrhythmias, and extent of coronary artery disease. Angina, ST segment responses, BP, and ventricular arrhythmias during early exercise testing are evaluated for their importance in determining prognosis. The concomitant use of thallium scintigraphy and radionuclide ventriculography seems to augment detection of multivessel disease and left-ventricular dysfunction. A practical strategy for the use of early exercise testing in the evaluation of post-Mis is provided.