Exercise testing soon after uncomplicated myocardial infarction. Prognostic value and safety

Modified exercise testing within three weeks of an acute myocardial infarction has been shown to be both a safe and feasible means for identifying patients at greater risk for subsequent cardiac events. An abnormal ECG and symptomatic response to exercise correlates with a higher morbidity and mortality. An ST-segment depression as well as angina are associated with a higher risk of recurrent ischemia and death. Elevation of the ST segment as well as inappropriately high heart rates and early development of fatigue and dyspnea are seen in patients with compromised left ventricular function. Exercise-induced premature ventricular contractions raise the possibility of increased sudden death. Patients identified to be at increased risk can be considered for more intensive medical or surgical treatment to reduce their morbidity and mortality. Patients considered to be at low risk can be spared needless invasive studies and unwarranted restriction of their physical activity. Patients may also accrue psychological benefit from these stress-test procedures.