Lack of correlation between the clinical assessment of cardiovascular status and exercise electrocardiography

One hundred and seventy-one patients who had had a myocardial infarction were evaluated at the Institute for Aviation Medicine, Pretoria. Patients were graded according to the New York City Heart Association classification of cardiac functional capacity and then subjected to exercise electrocardiography. Only 20% of the 74 patients whose exercise electrocardiograms revealed ischaemic heart disease felt that their cardiovascular function was limiting their daily activity. This lack of correlation between the two forms of assessment was highly significant (P less than 0,0001). It is therefore concluded that clinical evaluation of an individual with known ischaemic heart disease may be misleading.