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Diagnosis of chest pain. Pluses and minuses of stress tests

L H Seager1

  • 1Southern California Permanente Medical Group, Woodland Hills.

Postgraduate Medicine
|February 1, 1995
PubMed

Insights

Diagnosing chest pain relies on patient history and physical exams. Further tests like electrocardiographic stress tests are useful for angina but not for screening sudden death risk.

Area of Science:

  • Cardiology
  • Diagnostic Medicine

Background:

  • Chest pain diagnosis is crucial for patient outcomes.
  • Patient history and physical examination are primary diagnostic tools.

Purpose of the Study:

  • To evaluate the utility of various diagnostic methods for chest pain.
  • To determine the necessity of further studies based on initial findings.

Main Methods:

  • Analysis of diagnostic approaches for chest pain.
  • Review of the roles of history taking, physical examination, and stress tests.

Main Results:

  • Definite diagnosis of nonanginal chest pain requires no further studies.
  • Electrocardiographic stress tests offer prognostic and diagnostic value for angina.
  • Stress tests are ineffective for screening sudden death risk.
  • Radionuclide and echocardiographic stress tests are generally unnecessary due to cost.

Conclusions:

  • A thorough patient history and physical exam are paramount in diagnosing chest pain.
  • Selective use of electrocardiographic stress tests is appropriate for angina.
  • Advanced imaging stress tests are typically not indicated for chest pain evaluation.

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